Comparison of Knee Kinematics and Kinetics during Stair Descent in Single- and Multi-Radius Total Knee Arthroplasty

2019 ◽  
Vol 33 (10) ◽  
pp. 1020-1028 ◽  
Author(s):  
Bonnie Sumner ◽  
John McCamley ◽  
David J. Jacofsky ◽  
Marc C. Jacofsky
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
The Body ◽  
Stair Descent ◽  
Flexion Extension ◽  
Postoperative Time ◽  
Total Knee ◽  
Infrared Cameras ◽  
Kinematics And Kinetics

AbstractDespite continuing advances, nearly 20% of patients remain dissatisfied with their total knee arthroplasty (TKA) outcomes. Single-radius (SR) and multiradius (MR) TKA designs are two commonly used knee replacement designs based on competing theories of the flexion/extension axis of the knee. Our aim was to characterize stair descent kinematics and kinetics in SR and MR TKA subjects. We hypothesized that 1 year after TKA, patients who received SR TKA will more closely replicate the knee kinematics and kinetics of healthy age-matched controls during stair descent, than will MR TKA patients. SR subjects (n = 12), MR subjects (n = 12), and age-matched controls (n = 12) descended four stairs affixed to force platforms, while 10 infrared cameras tracked markers attached to the body to collect kinematic and kinetic data. Both patient groups had improvements in stair descent kinetics and kinematics at the 1-year postoperative time point. However, SR TKA subjects were indistinguishable statistically from age-matched controls, while MR TKA subjects retained many differences from controls. Similar to previous reports for level walking, the SR knee design performs closer to healthy controls than MR knees during stair descent. This study demonstrates that patients who receive SR TKA have more improved kinematic normalization during stair descent postoperatively than those who received an MR TKA.

Comparison of Knee Kinematics and Kinetics during Stair Ascent in Single-Radius and Multiradius Total Knee Arthroplasty

2018 ◽  
Vol 32 (09) ◽  
pp. 872-878 ◽  
Author(s):  
Bonnie Sumner ◽  
John D. McCamley ◽  
David J. Jacofsky ◽  
Marc C. Jacofsky
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Power Production ◽  
Healthy Controls ◽  
Stair Ascent ◽  
Total Knee ◽  
Kinetics Of ◽  
Kinematics And Kinetics ◽  
Single Radius

AbstractTraditionally total knee arthroplasty (TKA) design has been based on theories of the movement of the healthy knee joint. Currently, there are two competing theories on the flexion/extension axis of rotation of the knee with disparate radii of rotation, and thus differing movement patterns. The purpose of our study was to compare stair ascent kinematics and kinetics of single-radius (SR) and multiradius (MR) TKA subjects. We hypothesized that the knee kinematics and kinetics of SR TKA patients would more closely replicate healthy age matched controls during stair ascent than MR TKA patients, 1 year after TKA. Both patient groups had large improvements in biomechanical and clinical outcome measures following surgical intervention. However, the SR knee design performs closer to healthy controls than MR knees during stair ascent, supporting results that have been previously obtained for level walking. SR TKA subjects demonstrated reduced power production and sagittal moment compared with controls, albeit more than MR TKA subjects. This study demonstrates that patients who receive SR TKA have kinematics more closely aligned to normal patterns postoperatively than those who received an MR TKA. The power production and sagittal moment of the healthy controls most closely match previously published values of younger adults, SR TKA group most closely matches older adults, while the MR TKA group has lower power production and sagittal moments than either previously published age group. This strongly suggests that the biomechanical differences found in this study are evidence of functional deficiencies. Further research is needed to determine how these deficiencies progress with patient aging.

STRUCTURAL RESPONSES OF A NOVEL HIGH FLEXION KNEE (SS316–UHMWPE) USED IN TOTAL KNEE ARTHROPLASTY USING FINITE ELEMENT ANALYSIS

2009 ◽  
Vol 04 (03) ◽  
pp. 289-298 ◽  
Author(s):  
SUDESH SIVARASU ◽  
LAZAR MATHEW
Keyword(s):  
Finite Element ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Maximum Yield ◽  
Slight Modification ◽  
The Body ◽  
Element Analysis ◽  
Linear Deformation ◽  
Flexion Extension ◽  
Total Knee

The application of finite element modeling in medical applications has been evolving as the field of high importance especially in the development of medical. The generic artificial knee implants used in the total knee arthroplasty have the restriction in its range of motion with around 90 degrees. A new design allowing flexion extension range of over 120 degrees has been designed with a view to facilitate partial squatting and the same is used for the analysis purpose. The loading conditions of 10 times the body weight are considered. Finite element analyses of this design have been carried out based on standard biomaterial used in orthopaedic implants. In this paper we discuss the results of analyses of an artificial knee with stainless steel alloy. The results of the analyses were used in identifying areas of extreme stresses within the design and the spot prone for higher deformation. Based on these results slight modification on the designs was carried out. The results are also verified whether the body is within the linear deformation levels. As the results obtained were very satisfactory the models have been recommended for prototyping. It is verified from the results that the new models respond positive till a load of 300 kg and then they enter into the maximum yield stress levels. However, in reality, the loading on an artificial knee is less than 300 kg. So the results are inferred positive and the models were sent for prototyping.

scholarly journals Finite-Element-Based Design Optimisation of a Novel High Flexion Knee Used in Total Knee Arthroplasty

2008 ◽  
Vol 5 (2) ◽  
pp. 77-87 ◽  
Author(s):  
Sudesh Sivarasu ◽  
Lazar Mathew
Keyword(s):  
Finite Element ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Slight Modification ◽  
The Body ◽  
Finite Element Analyses ◽  
Linear Deformation ◽  
Extreme Stress ◽  
Flexion Extension ◽  
Total Knee

The application of finite-element modelling in medical applications has been evolving as a field of high importance in recent times. Total knee arthroplasty (TKA) has been in existence for over 6 decades. The generic artificial knee implants used in the TKA have a restricted range of motion of around 90 degrees. A new design allowing a flexion extension range of over 120 degrees was designed and is used for analysis. Loading conditions of 10 times the body weight are considered. The finite-element analyses of the designs were carried out based on standard biomaterials used in orthopaedic implants. The results of the analyses were used in identifying areas of extreme stress within the design and the spots prone to higher deformation. On the basis of these results slight modification of the designs was carried out. The results are also verified whether the body is within the linear deformation levels. The results obtained were very satisfactory and based on these results the models have been recommended for prototyping.

scholarly journals Pre-Planned and Non-Planned Agility in Patients Ongoing Rehabilitation after Knee Surgery: Design, Reliability and Validity of the Newly Developed Testing Protocols

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 146
Author(s):  
Ivan Peric ◽  
Miodrag Spasic ◽  
Dario Novak ◽  
Sergej Ostojic ◽  
Damir Sekulic
Keyword(s):  
Total Knee Arthroplasty ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Arthroscopic Surgery ◽  
The Body ◽  
Clinical Population ◽  
Pearson's R ◽  
Total Knee ◽  
Type Of Surgery ◽  
Pearson’S R

Background: Due to its association with the risk of falling and consequent injury, the importance of agility is widely recognized, but no study so far has examined the different facets of agility in an untrained/clinical population. The aim of this study was to evaluate the reliability, validity, and correlates of newly developed tests of non-planned agility (NPA) and pre-planned agility (PPA) in an untrained/clinical sample. Methods: The sample comprised 38 participants older than 40 years (22 females, age: 56.1 ± 17.3 years, height: 170.4 ± 10.8 cm, mass: 82.54 ± 14.79 kg) who were involved in a rehabilitation program following total knee arthroplasty and knee arthroscopy. Variables included age, gender, type of surgery, history of fall, anthropometrics/body composition, and newly developed tests of NPA and PPA. Results: The results showed the high inter-testing- (ICC > 0.95, CV < 9%), and intra-testing-reliability (ICC > 0.96, CV < 9) of the newly developed tests. PPA and NPA were found to be valid in differentiation between age groups (>50 yrs. vs. <50 yrs.), and genders, with better performance in younger participants and males. Only NPA differentiated participants according to type of surgery, with better performance in those who had arthroscopic surgery, than those who had total knee arthroplasty. No differences in NPA and PPA were established between groups based on fall-history. In females, the body mass (Pearson’s r = 0.58 and 0.59, p < 0.001) and body fatness (Pearson’s r = 0.64 and 0.66, p < 0.001) were negatively correlated, while the lean body mass (Pearson’s r = 0.70 and 0.68, p < 0.001) was positively correlated with PPA and NPA. The NPA and PPA were highly correlated (Pearson’s r = 0.98, p < 0.001). Conclusions: We found that the proposed tests are reliable when evaluating agility characteristics in an untrained/clinical population after knee arthroplasty/arthroscopy. Further evaluation of the specific validity of the proposed tests in other specific subsamples is warranted.

Patient function after a posterior stabilizing total knee arthroplasty: cam–post engagement and knee kinematics

2008 ◽  
Vol 16 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Jeremy F. Suggs ◽  
George R. Hanson ◽  
Sang Eun Park ◽  
Angela L. Moynihan ◽  
Guoan Li
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Total Knee

scholarly journals Bone Cement Solidifiliation Influence the Limb Alignment and Gap Balance during TKA

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Dongquan Shi ◽  
Xingquan Xu ◽  
Anyun Guo ◽  
Jin Dai ◽  
Zhihong Xu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Cement ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Statistical Significance ◽  
Mechanical Alignment ◽  
Early Loosening ◽  
Flexion Extension ◽  
Before And After ◽  
Total Knee

Introduction. Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during fixation of the femoral and tibial component is an essential step in performing a successful total knee arthroplasty. Bone cement is used to solidify the bone and prosthesis. Thickness imbalance of bone cement leads to the deviation of mechanical alignment. To estimate the influence of bone cement, a retrospective study was conducted.Materials and Methods. A total of 36 subjects were studied. All the TKA were performed following the standard surgical protocol for navigated surgery by medial approach with general anaesthesia. Prostheses were fixed by bone cement.Results. We compared the mechanical axis, flexion/extension, and gap balance before and after cementation. All the factors were different compared with those before and after cementation. Internal rotation was reached with statistical significance (P=0.03).Conclusion. Bone cement can influence the mechanical axis, flexion/extension, and gap balance. It also can prompt us to make a change when poor knee kinematics were detected before cementation.

Effect of Gait on Patellofemoral Mechanics

2008 ◽  
Author(s):  
Jeffrey E. Bischoff ◽  
Justin S. Hertzler
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Studies ◽  
Patellofemoral Joint ◽  
Knee Kinematics ◽  
Component Design ◽  
Total Knee ◽  
The Impact ◽  
Reconstructed Knee

Computational modeling of the reconstructed knee is an important tool in designing components for maximum functionality and life. Utilization of boundary conditions consistent with in vivo gait loading in such models enables predictions of knee kinematics and polyethylene damage [1–4], which can then be used to optimize component design. Several recent clinical studies have focused on complications associated with the patellofemoral joint [5–6], highlighting the need to better understand the mechanics of this compartment of total knee arthroplasty (TKA). This study utilizes a computational model to characterize the impact of gait loading on the mechanics of the patella in TKA.

Anatomic-like polyethylene insert could improve knee kinematics after total knee arthroplasty — A computational assessment

2011 ◽  
Vol 26 (6) ◽  
pp. 612-619 ◽  
Author(s):  
Yu-Liang Liu ◽  
Kun-Jhih Lin ◽  
Chang-Hung Huang ◽  
Wen-Chuan Chen ◽  
Chih-Hui Chen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Polyethylene Insert ◽  
Total Knee
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