Midterm Comparison of Tibial Fixation between Posterior Cruciate-Retaining and Substituting Porous Tantalum Total Knee Arthroplasty: Three-Dimensional Computed Tomography Analysis

2019 ◽  
Vol 34 (01) ◽  
pp. 047-056
Author(s):  
Takao Kaneko ◽  
Norihiko Kono ◽  
Yuta Mochizuki ◽  
Masaru Hada ◽  
Shinya Toyoda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Bone Quality ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Three Dimensional ◽  
Porous Tantalum ◽  
Cruciate Retaining ◽  
Significant Difference ◽  
Total Knee

AbstractPorous tantalum tibial component is durable with excellent bone ingrowth, higher knee scores, and long-term survivorship. However, to our knowledge, the effect of posterior cruciate-retaining (CR) and posterior cruciate-substituting (PS) porous tantalum tibial component has not been reported. The aim of the current study was to investigate the prosthetic bone quality between CR porous tantalum tibial component and PS using three-dimensional multi-detector-row computed tomography (3D-MDCT). Porous twenty-two (22) CR total knee arthroplasties and 22 PS received 3D-MDCT at every 6 months up to 5.5 years postoperatively to assess prosthetic bone quality (bone marrow contents/tissue volumes [BMC/TV, mg/cm3]) underneath the pegs of porous tantalum modular tibial component. Clinical outcomes (Knee Society score [KSS], Western Ontario and McMaster Universities (WOMAC), FJS-12, Patella score) were evaluated at a minimum follow-up period of 5.5 years. No statistically significant differences were found in age, gender, body mass index, KSS, and BMC/TV volumes in the proximal tibia between the two groups before total knee arthroplasty (TKA). There were also no significant differences between the CR and PS groups with regard to BMC/TV at every 6 months up to 5.5 years after TKA. At 5.5 years postoperatively, there was no significant difference between the two groups in terms of the KSS, WOMAC, forgotten joint score (FJS-12), and Patella score. The present study revealed that the prosthetic bone quality of the CR porous tantalum tibial component and PS were equivalent at every 6 months up to 5.5 years after TKA. This study reflects level II evidence.

Imaging of symptomatic total knee arthroplasty with cone beam computed tomography

2018 ◽  
Vol 59 (12) ◽  
pp. 1500-1507 ◽  
Author(s):  
Antti Jaroma ◽  
Juha-Sampo Suomalainen ◽  
Lea Niemitukia ◽  
Tarja Soininvaara ◽  
Jari Salo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Cone Beam Computed Tomography ◽  
Tibial Component ◽  
Cone Beam ◽  
Component Rotation ◽  
Symptomatic Knee ◽  
Total Knee ◽  
Component Loosening

Background Computed tomography (CT) can be used to assess the rotational alignment of prosthesis components to identify possible underlying causes of symptomatic total knee arthroplasty (TKA). The use of cone beam computed tomography (CBCT) for the imaging of extremities is relatively new, although it has been widely used in dental imaging. Purpose To assess the intra- and inter-observer reproducibility of CBCT, as well as to validate CBCT for TKA component and periprosthetic bone diagnostics. Material and Methods CBCT scans were performed on 18 patients the day before a scheduled revision TKA, from which the intra- and inter-observer reproducibility were assessed. Component rotation and loosening were evaluated. Perioperative bone defects were classified. Results The inter-observer intraclass coefficient correlation (ICC) for femoral component rotation was 0.41 (95% confidence interval [CI] = 0.12–0.69). For the tibial component, the ICC was 0.87 (95% CI = 0.74–0.94). Intra-observer reproducibilities were 0.70 (95% CI = 0.35–0.87) and 0.92 (95% CI = 0.80–0.97), respectively. The sensitivity for tibial component loosening was 97% and the specificity was 85%. The reliability of bone defect classification was only weak to moderate. Conclusion Two-dimensional (2D) CBCT scanning provides reliable and reproducible data for determining the rotation of femoral and tibial components, while showing minor overestimation of tibial component loosening. CBCT is a promising new tool for the evaluation of symptomatic knee arthroplasty patients, with a substantially lower radiation dose compared to conventional 2D multi-slice CT.

scholarly journals Morphometric Analysis of Superior Articular Surface of Tibia in Dry Cadaveric Bones

2019 ◽  
Vol 15 (4) ◽  
pp. 287-290
Author(s):  
Ruku Pandit ◽  
Nitasha Sharma
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Articular Surface ◽  
Baseline Data ◽  
Lateral Condyle ◽  
Medial Condyle ◽  
Significant Difference ◽  
Total Knee ◽  
The Right

Background: Total knee arthroplasty is the most cost effective and rapidly evolving technique. The success of procedure relies on appropriate sizing of tibial component, for which elaborate information of various dimensions of upper surface of tibia is mandatory. Hence, this study is aiming to generate baseline data on antero-posterior and transverse measurements of medial and lateral condyles and intercondylar area of upper surface of tibia. Methods: The study was conducted in 42 dry human cadaveric tibia with unidentified age and sex, in the Department of Anatomy, College of Medical Sciences and Teaching Hospital, Chitwan. The antero-posterior and transverse measurements of medial and lateral condyles and intercondylar area of tibia were recorded in millimeter (mm) with digital Vernier calipers. The data was analysed using SPSS version 16.0. Results: The antero-posterior and transverse measurements of medial condyle of tibia were 43.00±5.95 mm and 25.21±8.08 mm respectively on the right side and 45.33±5.36 mm and 27.43±8.57 mm respectively on the left side and that of lateral condyle were 37.94±5.64 mm and 25.21±8.71 mm respectively on the right side and 41.03±3.65 mm and 27.06±8.83 mm respectively on the left side. The antero-posterior and transverse measurements of intercondylar area of tibia were 47.49±6.31 mm and 15.71±3.93 mm respectively on the right side and 49.24±6.91 mm and 15.02±3.88 mm respectively on the left side. The variation in the measurements between right and left tibia showed significant difference only for antero-posterior measurement of lateral condyle (p<0.05). Conclusions: The study generates baseline data regarding various anthropometric measurements of upper surface of tibia, which will assist the orthopedic surgeon to create a resected bony surface identical to the tibial component of an implant in unilateral and total knee arthroplasty. Keywords: measurement; morphometric; superior articular surface; tibial condyles.

scholarly journals Three-dimensional printed porous tantalum prosthesis for treating inflammation after total knee arthroplasty in one-stage surgery – a case report

2019 ◽  
Vol 48 (3) ◽  
pp. 030006051989128
Author(s):  
Fuyou Wang ◽  
Hao Chen ◽  
Pengfei Yang ◽  
Aikeremujiang Muheremu ◽  
Peng He ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Chronic Inflammation ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Bone Defects ◽  
Left Knee ◽  
Severe Osteoporosis ◽  
Porous Tantalum ◽  
3D Printed ◽  
Total Knee

Chronic inflammation and bone defects after total knee arthroplasty are a challenge for the orthopedic surgeon. There have been few reports on application of a three-dimensional (3D) printed porous tantalum prosthesis in such situations. We report an 83-year-old female patient who presented to our clinic with consistent pain of the left knee for 10 years and a severe decline in mobility for 2 years. Chronic inflammation, loosening of a tibial prosthesis with a bone defect, and severe osteoporosis were diagnosed. The patient was treated with computer designed and manufactured, personalized, 3D printed porous pure tantalum pad-assisted left total knee arthroplasty. The surgery went smoothly and the patient achieved a satisfactory recovery after surgery. A 3D printed porous tantalum prosthesis can be used to reconstruct tibial bone defects in patients with chronic inflammation after joint replacement surgeries.

Extramedullary Guide Alignment Is not Affected by Obesity in Primary Total Knee Arthroplasty

2020 ◽  
Author(s):  
Jocelyn Compton ◽  
Jessell Owens ◽  
Jesse Otero ◽  
Nicolas Noiseux ◽  
Timothy Brown
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Primary Total Knee Arthroplasty ◽  
Coronal Plane ◽  
Coronal Alignment ◽  
Primary Tkas ◽  
Significant Difference ◽  
Total Knee ◽  
Valgus Alignment

AbstractCoronal alignment of the tibial implant correlates with survivorship of total knee arthroplasty (TKA), especially in obese patients. The purpose of this study was to determine if obesity affects coronal plane alignment of the tibial component when utilizing standard extramedullary tibial guide instrumentation during primary TKA. A retrospective review from June 2017 to February 2018 identified 142 patients (162 primary TKAs). There were 88 patients (100 knees) with body mass index (BMI) < 35 kg/m2 and 54 patients (62 knees) with BMI ≥ 35.0 kg/m2. The cohorts did not differ in age (p = 0.37), gender (p = 0.61), or Charlson's comorbidity index (p = 0.54). Four independent reviewers measured the angle between the base of the tibial component and the mechanical axis of the tibia on the anteroposterior view of long-leg film at first postoperative clinic visit. Outliers were defined as patients with greater than 5 degrees of varus or valgus alignment (n = 0). Reoperations and complications were recorded to 90 days postoperatively. There was no significant difference in mean tibial coronal alignment between the two groups (control alignment 90.8 ± 1.2 degree versus obese alignment 90.8 ± 1.2 degree, p = 0.91). There was no difference in varus versus valgus alignment (p = 0.19). There was no difference in the number of outliers (two in each group, p = 0.73). There was no difference in rate of reoperation (p = 1.0) or complication (p = 0.51). Obesity did not affect coronal plane alignment of the tibial component when using an extramedullary guide during primary TKA in our population.

Three-dimensional Analysis of Computed Tomography–Based Navigation System for Total Knee Arthroplasty

2009 ◽  
Vol 24 (7) ◽  
pp. 1103-1110 ◽  
Author(s):  
Hideki Mizu-uchi ◽  
Shuichi Matsuda ◽  
Hiromasa Miura ◽  
Hidehiko Higaki ◽  
Ken Okazaki ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Dimensional Analysis ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Three Dimensional ◽  
Total Knee

Evaluation and Analysis of the Onlay Patellar Component in Total Knee Arthroplasty

2010 ◽  
Vol 97-101 ◽  
pp. 3773-3776 ◽  
Author(s):  
Chien Wei Liu ◽  
Chia Chi Lo ◽  
Ching Sung Wang ◽  
Chen Tung Yu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Three Dimensional ◽  
Element Model ◽  
Clinical Results ◽  
Original Design ◽  
Design Modification ◽  
Patellar Component ◽  
Significant Difference ◽  
Total Knee

Complications in total knee arthroplasty (TKA), which may include the inaccuracy of the implantation and the poor component design, can cause major failures in the TKA. Therefore, the present investigation studies the onlay knee implants commonly used clinically to find the major causes of the damage to artificial patella by the computer aided analysis of the three-dimensional finite element model of the artificial patello-femoral joint built through reverse engineering. Results showed that although a significant difference is found in the condition and the state of the stress distribution generated as the patello-femoral joint changes with the flexion of the knees, this variation is still within the tolerable range; but the patellar lateral tilt is something that caught our attention. Furthermore, through the comparison between the study and the clinical results, this investigation concludes that the bone cement on the implant interface is the major cause for the breaking of the pegs, and is not related to the original design of the patella. This study also discovers that slight design modification on the parts of commonly used artificial joints may effectively reduce surgical failure rate; therefore, a more robust design configuration for patellar pegs is proposed.

The Accuracy of Computed Tomography-Based, Three-Dimensional Implant Planning in Robotic-Assisted Total Knee Arthroplasty

2021 ◽  
Author(s):  
Kevin B. Marchand ◽  
Hytham S. Salem ◽  
Kevin K. Mathew ◽  
Steven F. Harwin ◽  
Michael A. Mont ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Predictive Accuracy ◽  
Outpatient Surgery ◽  
Three Dimensional ◽  
Patient Specific ◽  
Robotic Assisted ◽  
Preoperative Ct ◽  
Total Knee

AbstractAdvanced imaging used in robotic-assisted total knee arthroplasty (TKA), such as computed tomography (CT)-based three-dimensional (3D) planning, may provide an accurate means of implant sizing preoperatively. The purpose of this study was to examine preoperative CT-based implant planning accuracy for robotic-assisted TKA in patients who have (1) varus deformities, (2) valgus deformities, (3) neutral alignment, and (4) retained hardware. A total of 393 patients underwent a robotic-assisted TKA by a single surgeon received preoperative CT scans. The surgeon reviewed the CT-based model preoperatively and recorded the expected size of the components. The final implants used in each case were recorded and compared with the surgeon's preoperative plan. In all groups of patients, the surgeon's CT-based implant plan was within one size of the implant utilized 100% of the time for both the tibiae and femora. Overall, the surgeon was exactly matched in 319 (81%) and 315 (80%) cases for the femoral and tibial components, respectively. For the femoral component, the mean age for patients in whom the original plan was exactly matched was younger than those whose implants were upsized and older than patients those implants were downsized (p = 0.024). Other patient demographics and preoperative knee alignment were not associated with predictive accuracy for femoral or tibial components. Our results demonstrate how preoperative CT-based, 3D planning for robotic-assisted TKA is accurate to within one size of the components in every case (100%), and exactly matched in 80%. The results of this study are important because they demonstrate how CT-based preoperative implant planning for TKA is reliable and accurate across all native knee alignments and other patient-specific factors. In addition, they build on a previous study by the same single surgeon, demonstrating that predictive ability can improve over time. This may be important as we move toward more outpatient surgery with less ability for prostheses inventory at ambulatory sites.

Analysis of Tibial Component Rotation Following Total Knee Arthroplasty Using 3D High Definition Computed Tomography

2013 ◽  
Vol 28 (8) ◽  
pp. 106-111 ◽  
Author(s):  
Glade E. Roper ◽  
Adam D. Bloemke ◽  
Catherine C. Roberts ◽  
Mark J. Spangehl ◽  
Henry D. Clarke
Keyword(s):  
Computed Tomography ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
High Definition ◽  
Component Rotation ◽  
Total Knee ◽  
Tibial Component Rotation
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