scholarly journals Evaluation of anatomical axis-joint center distance and anatomical axis-joint center ratio in distal femur and proximal tibia in coronal plane of Indian population

2021 ◽  
pp. 101513
Author(s):  
Vikas Maheshwari ◽  
Mohit Dhingra ◽  
Gagan Yadav
Keyword(s):  
Indian Population ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Coronal Plane ◽  
Joint Center ◽  
Center Distance ◽  
Anatomical Axis

Hisotological and radiographic determination of the age of physeal closure of the distal femur, proximal tibia, and proximal fibula of the New Zealand white rabbit

1994 ◽  
Vol 12 (5) ◽  
pp. 747-749 ◽  
Author(s):  
Moises Kaweblum ◽  
Maria Del Carmen Aguilar ◽  
Eduardo Blancas ◽  
Jaime Kaweblum ◽  
Wallace B. Lehman ◽  
...  
Keyword(s):  
New Zealand ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Zealand White Rabbit ◽  
Proximal Fibula ◽  
New Zealand White Rabbit ◽  
Physeal Closure

scholarly journals Why knees move like they do: A simulation of the effect of varying distal femoral and proximal tibial anatomy on coronal kinematic curve morphology

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0016
Author(s):  
Peter McEwen
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Coronal Plane ◽  
Curve Shape ◽  
Femoral Rotation ◽  
Full Extension ◽  
Reciprocal Effect ◽  
Maximal Deviation ◽  
Total Knee

Objective: Computer assisted total knee arthroplasty (CA TKA) platforms can provide detailed kinematic data that is presented in various forms including a coronal plane graphic that maps the flexion arc from full extension to deep flexion. Graphics obtained from normal tibiofemoral articulations reveal varied and complex kinematic patterns that have yet to be explained. An understanding of what drives curve variation would allow prediction of how a preoperative curve would be altered by total knee arthroplasty. Implant position could then be tailored to maintain a desirable curve or avoid an undesirable one. Methods: An articulated lower limb saw bone with a stable hip pivot was obtained. Adjustable osteotomies were created so that femoral torsion, femoral varus-valgus and tibial varus-valgus could be altered independently. The saw bone limb was registered with a CA TKA navigation system using the posterior condyles as a rotational axis. Axial and coronal plane morphology of the distal femur and coronal plane morphology of the proximal tibia were systematically altered and a kinematic curve obtained for each morphologic combination. Femoral rotational position was varied from 100 of internal torsion to 100 of external torsion in 20 increments. Similarly, femoral coronal position was varied from 20 of varus to 60 of valgus and tibial coronal position was varied from 5.50 of varus to 10 of valgus. Curves were obtained by manually flexing the joint through a full range of motion with the femoral condyles in contact with proximal tibia at all times. Results: Varying femoral rotation has no effect in full extension but drives the curve away from neutral as the knee flexes. Maximal deviation is seen at around 900 of flexion. Internal torsion drives the curve into valgus as the knee flexes and external torsion has a reciprocal effect. Varying femoral varus-valgus causes maximal deviation from neutral in full extension. Femoral varus drives the curve from varus in extension towards valgus as the knee flexes with the effect peaking in maximal flexion. Femoral valgus has a reciprocal effect. Varying tibial varus-valgus has no effect on curve shape but does move the curve either side of neutral. Complex (parabolic) curves are caused by large rotations or the opposing effects of femoral varus-valgus and femoral rotation. The modal human anatomy of slight femoral internal rotation, slight femoral valgus and slight tibial varus produces a straight neutral curve. Conclusion: Kinematic curve shape is driven by distal femoral anatomy. The typical changes made to distal femoral articular anatomy in TKA by externally rotating a neutrally orientated femoral component will bring many native curves towards neutral. Externally rotating when the preoperative curve begins neutral and drives into varus as the knee flexes will drive the curve harder into varus. Conversely, kinematic femoral placement will reconstitute the premorbid curve morphology. Which outcome is preferable has yet to be determined.

Analysis of an Early Intervention Tibial Component for Medial Osteoarthritis

2014 ◽  
Vol 136 (6) ◽  
Author(s):  
M. E. Chaudhary ◽  
P. S. Walker
Keyword(s):  
Early Intervention ◽  
Tibial Component ◽  
Strain Energy ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Metal Plate ◽  
Thin Metal ◽  
Bone Resection ◽  
Component Loosening ◽  
Thin Metal Plate

Tibial component loosening is an important failure mode in unicompartmental knee arthroplasty (UKA) which may be due to the 6–8 mm of bone resection required. To address component loosening and fixation, a new early intervention (EI) design is proposed which reverses the traditional material scheme between femoral and tibial components. The EI design consists of a plastic inlay for the distal femur and a thin metal plate for the proximal tibia. With this reversed materials scheme, the EI design requires minimal tibial bone resection compared with traditional UKA. This study investigated, by means of finite element (FE) simulations, the advantages of a thin metal tibial component compared with traditional UKA tibial components, such as an all-plastic inlay or a metal-backed onlay. We hypothesized that an EI tibial component would produce comparable stress, strain, and strain energy density (SED) characteristics to an intact knee and more favorable values than UKA components, due primarily to the preservation of dense cancellous bone near the surface. Indeed, FE results showed that stresses in the supporting bone for an EI design were close to intact, while stresses, strains, and strain energy densities were reduced compared with an all-plastic UKA component. Analyzed parameters were similar for an EI and a metal-backed onlay, but the EI component had the advantage of minimal resection of the stiffest bone.

scholarly journals GCT of knee treated with modular prosthesis-case presentation

2019 ◽  
Vol 2 (1) ◽  
pp. 18-22
Author(s):  
Alexandru Papuc ◽  
Ioan Mihai Japie ◽  
Traian Ciobanu ◽  
Octavian Nutiu ◽  
Dragos Radulescu ◽  
...  
Keyword(s):  
Bone Tumors ◽  
Benign Tumor ◽  
Distal Femur ◽  
Proximal Tibia ◽  
Metastatic Potential ◽  
Left Knee ◽  
Case Presentation ◽  
Previous Medical History ◽  
Malignancy Potential

AbstractThe GCT is an aggressive benign tumor with metastatic potential, most often within the lungs in 2-3% of the patients. It makes about 5% of total bone tumors and about 15% of total benign bone tumors.The maximum incidence occurs between 30 and 40 years old, most frequently affecting the long bones epiphysis (distal femur, proximal tibia, and distal radius).We report the case of a 50-year-old female, with no previous medical history, admitted in the emergency department (ED) for significant pain and functional impairment of the left knee. Clinical examination and imaging tests established the diagnosis of distal femoral tumor.The patient underwent surgical segmental resection of the tumor within oncological limits and subsequent arthroplasty with cemented modular tumoral prosthesis was performed.Even if the GCT is a benign tumor, it has an aggressive behavior and malignancy potential with an important impact on quality of life. Due to localization, this type of tumor can quickly manifest clinically, which allows an early diagnosis and a less invasive surgical technique.

scholarly journals Mechanical and Anatomical Axis in Total Ankle Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0008
Author(s):  
Ali-Asgar Najefi ◽  
Andrew Goldberg
Keyword(s):  
Lower Limb ◽  
Mechanical Axis ◽  
Normal Group ◽  
Total Ankle Arthroplasty ◽  
Coronal Plane ◽  
Patient Specific ◽  
Ankle Arthroplasty ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Anatomical Axis

Category: Ankle Arthritis Introduction/Purpose: Inadequate correction of alignment in the coronal, sagittal or axial planes will inevitably lead to failure of the Total Ankle Arthroplasty (TAA). The mechanical axis of the lower limb (MAL), the mechanical axis of the tibia (MAT) and the anatomical axis of the tibia (AAT) are three recognized coronal plane measurements using plain radiography. The relationship between anatomical and mechanical axes depends on the presence of femoral or tibial deformities from trauma or inherited conditions, or previous corrective or replacement surgery. Ankle arthroplasty relies heavily on preoperative radiographs or CT scans and the purpose of this study was to assess whether MAL, MAT and AAT are the same in a cohort of patients upon which placement of TAA is considered. Methods: We analysed 75 patients operated on between 2015 and 2016 at a specialist tertiary centre for elective orthopaedic surgery. All patients had a pre-operative long leg radiograph. They were split into 2 groups. The first group had known deformity proximal to the ankle (such as previous tibial or femoral fracture, severe arthritis, or previous reconstructive surgery) and the second group had no clinically detectable deformity. The MAL, MAT and AAT were assessed and the difference between these values was calculated. Results: There were 54 patients in the normal group, and 21 patients in the deformity group. Overall, 25 patients(33%) had a difference between all three axes of less than 1 degree. In 33 patients(44%), there was a difference in one of the axes of ≥2 degrees. There was no significant difference between MAT and AAT in patients in the normal group(p=0.6). 95% of patients had a difference of <1 degree. There was a significant difference between the MAT and AAT in patients in the deformity group(p<0.01). In the normal group, 39 patients(73%) had a difference of <2 degrees between the AAT and MAL. In the deformity group, only 10 patients (48%) had a difference of <2 degrees.In fact, 24% of patients had a difference ≥3 degrees. Conclusion: Malalignment in the coronal plane in TAA may be an issue that we have not properly addressed. Up to 66% of patients without known deformity may have a TAA that is placed at least 1 degree incorrectly relative to the MAL. We recommend the use of full-length lower limb radiographs when planning a TAA in order to plan the placement of implants. The decision to perform extramedullary referencing, intramedullary referencing, or patient specific Instrumentation must be part of the pre-operative planning process.

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