Tibiofemoral Contact After Conventional and High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2003 ◽  
Author(s):  
Ephrat Most ◽  
Guoan Li ◽  
Harry E. Rubash
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Contact Point ◽  
Knee Kinematics ◽  
Testing System ◽  
High Flexion ◽  
Human Knee ◽  
Contact Points ◽  
Total Knee

The human knee is capable of flexing up to 160°, yet most patients do not achieve more than 120° after total knee arthroplasty (TKA). The translation of the tibiofemoral contact points with flexion is important in the overall understanding of knee kinematics and knee stability, particularly in high flexion. In this study, cadaveric knees were used in conjunction with a robotic testing system and TekScan® film to quantify the tibiofemoral contact between 0°–150° for two TKA designs. We found that, for both TKAs, with increasing knee flexion, the peak contact point moved posteriorly and that the contact area decreased with increasing knee flexion.

In Vivo Comparison of Knee Kinematics Before and After High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2010 ◽  
Vol 25 (6) ◽  
pp. 964-969 ◽  
Author(s):  
Atsushi Kitagawa ◽  
Nobuhiro Tsumura ◽  
Takaaki Chin ◽  
Kazuyoshi Gamada ◽  
Scott A. Banks ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
Cruciate Retaining ◽  
High Flexion ◽  
Before And After ◽  
Total Knee

scholarly journals In vivo knee kinematics during high flexion after a posterior-substituting total knee arthroplasty

2009 ◽  
Vol 34 (4) ◽  
pp. 497-503 ◽  
Author(s):  
Angela L. Moynihan ◽  
Kartik M. Varadarajan ◽  
George R. Hanson ◽  
Sang-Eun Park ◽  
Kyung Wook Nha ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Kinematics ◽  
High Flexion ◽  
Total Knee ◽  
In Vivo Knee Kinematics

COMPARISON OF HIGH FLEXION DESIGN AND POSTERIOR STABILIZATION PROSTHESES OF TOTAL KNEE ARTHROPLASTY BY GAIT ANALYSIS

2009 ◽  
Vol 21 (01) ◽  
pp. 71-79
Author(s):  
Wen-Chi Tsai ◽  
Sheng-Chang Chen ◽  
Tung-Wu Lu ◽  
Hwa-Chang Liu
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Objective Assessment ◽  
Knee Prostheses ◽  
High Flexion ◽  
Significant Difference ◽  
Post Operation ◽  
Total Knee

Introduction: The primary goal of total knee arthroplasty (TKA) is to resolve knee destruction and associated problems at the end stages of diseases such as osteoarthritis and rheumatoid arthritis. High satisfactory rate has been reported in terms of pain relief and correction of deformity. However, the method for objective assessment of the outcome, such as range of motion (ROM) and quantitative evaluation of the clinical outcome of TKA, is to be confirmed. The purpose of this study was mandatory to investigate the ROM objectively and the newly designed prostheses. Materials and methods: The study was done in randomly selected patients who received dynamic measurement of knee function. Twenty-six patients participated in the study. They were divided into two groups (13 patients in A and 13 patients in B group), according to the knee prostheses they had received. Basic knee functions were evaluated in various dynamic activities, including nonweight bearing status of knee flexion, level walking, kneeling, and squatting, using computerized gait analysis techniques (Vicon 512 system). Passive knee ROM and static alignment were measured using traditional goniometer. HSS scores, physical, and neural examination were recorded. Results: After comparing patients in almost similar criteria, results have shown that there was no significant difference between two types of knee prostheses in randomly selective patients. Conclusion: Newly designed prostheses for achieving higher flexion angle cannot guarantee to provide better knee flexion for every patient. A patient, who can achieve higher knee flexion in pre-operative status, will have high flexion results in post-operative result. In other words, poor knee flexion function in pre-operation will lead to poor knee flexion function in post-operation status. Minor prosthesis design has little to do with the surgical outcome of knee flexion.

Postoperative Stiffening after Bicruciate-Retaining Total Knee Arthroplasty

2017 ◽  
Vol 31 (05) ◽  
pp. 453-458 ◽  
Author(s):  
Fidaa Al-Shakfa ◽  
James Moore ◽  
Lydia Mychaltchouk ◽  
Khaled Iguer ◽  
Frédéric Lavoie
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Flexion Contracture ◽  
Early Postoperative Period ◽  
Active Population ◽  
Total Knee ◽  
Comparative Cohort Study ◽  
Bcr Tka

AbstractBicruciate-retaining (BCR) total knee arthroplasty (TKA) has recently experienced a resurgence of popularity. It may be a good option among a younger, more active population because it restores knee kinematics better than other prosthetic designs. Results obtained in the first 100 BCR TKAs implanted with a simplified gap-balancing technique are reported, with special attention paid to knee flexion, through comparison with a cohort of 100 posterior-stabilized (PS) TKAs. We conducted a retrospective comparative cohort study of 100 BCR TKAs (90 patients) and 100 PS TKAs (88 patients). Knees with a BCR TKA lost significantly more flexion PS TKA in the early postoperative period when their preoperative flexion was less than 130 degrees (loss of 40 degrees vs. loss of 24 degrees). Postoperative range of motion was similar between BCR TKA and PS TKA when preoperative knee flexion was 130 degrees or more, and when there was no preoperative flexion contracture. Postoperative stiffening seems to be more frequent and of greater magnitude after BCR TKA, compared with PS TKA, in patients suffering from preoperative flexion stiffness. Further investigation on the causes of this phenomenon is warranted.

scholarly journals Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta analysis

2011 ◽  
Vol 35 (9) ◽  
pp. 1309-1319 ◽  
Author(s):  
Takanobu Sumino ◽  
Hemanth R. Gadikota ◽  
Kartik M. Varadarajan ◽  
Young-Min Kwon ◽  
Harry E. Rubash ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Meta Analysis ◽  
High Flexion ◽  
Total Knee

scholarly journals Improved knee flexion following high-flexion total knee arthroplasty

2012 ◽  
Vol 7 (1) ◽  
pp. 22 ◽  
Author(s):  
David R Lionberger ◽  
Mitchell D Eggers ◽  
Kathryn E Brewer ◽  
Li Fang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
High Flexion ◽  
Total Knee

scholarly journals Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

2014 ◽  
Vol 4 (2) ◽  
pp. 29-36
Author(s):  
Edward McPherson, MD FACS ◽  
Denise Portugal, MD ◽  
Matthew Dipane, BA ◽  
Sherif Sherif, MD
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Primary Total Knee Arthroplasty ◽  
Implant Design ◽  
Consecutive Series ◽  
High Flexion ◽  
Total Knee

This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA) procedures utilizing a technique to optimize knee flexion.  The main features include: (1)the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2) patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3)a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4)incorporation of a rapid recovery protocol with features to promote knee flexion.Results were categorized into three groups: low pre-op flexion (90 degrees and below), regular pre-op flexion (91-125 degrees), and high pre-op flexion (126 degrees and above).  Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years.  In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years.  Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years.In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.Keywords: Total knee arthroplasty, range of motion, high flexion, surgical technique, implant design, AP AxisLevel of Evidence:  AAOS Therapeutic Study Level III

scholarly journals Early Spatiotemporal Patterns and Knee Kinematics during Level Walking in Individuals following Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Xubo Wu ◽  
Lixi Chu ◽  
Lianbo Xiao ◽  
Yong He ◽  
Shuyun Jiang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Gait Pattern ◽  
Swing Phase ◽  
Knee Flexion Angle ◽  
Total Knee ◽  
Support Time

Purpose. With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. Methods. Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. Results. 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonoperated side. There was moderate to significant correlation between gait pattern and the dynamic knee kinematics. Conclusion. The gait abnormality of patients after TKA was associated with inadequate flexion of knees at swing phase and insufficient extension at stance phase as well as increased range of valgus.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

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