Iatrogenic femur fracture following medial femoral condyle flap harvest eventually requiring total knee arthroplasty in one patient

2018 ◽  
Vol 44 (3) ◽  
pp. 320-321 ◽  
Author(s):  
Ji H. Son ◽  
Aviram M. Giladi ◽  
James P. Higgins
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femur Fracture ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Total Knee

scholarly journals The Bony Resection Accuracy with Patient-Specific Instruments during Total Knee Arthroplasty: A Retrospective Case Series Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Liang Yuan ◽  
Bin Yang ◽  
Xiaohua Wang ◽  
Bin Sun ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Patient Specific ◽  
Lateral Tibial Plateau ◽  
Bone Resection ◽  
Total Knee

Purpose. Bony resection is the primary step during total knee arthroplasty. The accuracy of bony resection was highly addressed because it was deemed to have a good relationship with mechanical line. Patient-specific instruments (PSI) were invented to copy the bony resection references from the preoperative surgical plan during a total knee arthroplasty (TKA); however, the accuracy still remains controversial. This study was aimed at finding out the accuracy of the bony resection during PSI-assisted TKA. Methods. Forty-two PSI-assisted TKAs (based on full-length leg CT images) were analyzed retrospectively. Resected bones of every patient were given a CT scan, and three-dimensional radiographs were reconstructed. The thickness of each bony resection was measured with the three-dimensional radiographs and recorded. The saw blade thickness (1.27 mm) was added to the measurements, and the results represented intraoperative bone resection thickness. A comparison between intraoperative bone resection thickness and preoperatively planned thickness was conducted. The differences were calculated, and the outliers were defined as >3 mm. Results. The distal femoral condyle had the most accurate bone cuts with the smallest difference (median, 1.0 mm at the distal medial femoral condyle and 0.8 mm at the distal lateral femoral condyle) and the least outliers (none at the distal medial femoral condyle and 1 (2.4%) at the distal lateral femoral condyle). The tibial plateau came in second (median difference, 0.8 mm at the medial tibial plateau and 1.4 mm at the lateral tibial plateau; outliers, none at the medial tibial plateau and 1 (2.6%) at the lateral tibial plateau). Regardless of whether the threshold was set to >2 mm (14 (17.9%) at the tibial plateau vs. 12 (14.6%) at the distal femoral condyle, p > 0.05 ) or >3 mm (1 (1.3%) at the tibial plateau vs. 1 (1.2%) at the distal femoral condyle, p > 0.05 ), the accuracy of tibial plateau osteotomy was similar to that of the distal femoral condyle. Osteotomy accuracy at the posterior femoral condyle and the anterior femoral condyle were the worst. Outliers were up to 6 (15.0%) at the posterior medial femoral condyle, 5 (12.2%) at the posterior lateral femoral condyle, and 6 (15.8%) at the anterior femoral condyle. The percentages of overcut and undercut tended to 50% in most parts except the lateral tibial plateau. At the lateral tibial plateau, the undercut percentage was twice that of the overcut. Conclusion. The tibial plateau and the distal femoral condyle share a similar accuracy of osteotomy with PSI. PSI have a generally good accuracy during the femur and tibia bone resection in TKA. PSI could be a kind of user-friendly tool which can simplify TKA with good accuracy. Level of Evidence. This is a Level IV case series with no comparison group.

scholarly journals Atraumatic Fracture of the Medial Femoral Condyle of a Total Knee Arthroplasty

2021 ◽  
Vol 8 ◽  
pp. 222-225
Author(s):  
Ricardo Ocampo ◽  
Eric Azua ◽  
Matthew Presti ◽  
Lynn Voss
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Total Knee

scholarly journals Anterior referencing versus posterior referencing in total knee arthroplasty: a prospective observational study

2016 ◽  
Vol 3 (1) ◽  
pp. 66 ◽  
Author(s):  
Preetesh Choudhary ◽  
Skand Bahre ◽  
Vinay Tantuway ◽  
Ashok Nagla ◽  
Avinash Jain ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Prospective Observational Study ◽  
Femoral Condyle ◽  
Posterior Instrumentation ◽  
Medial Femoral Condyle ◽  
Femoral Rotation ◽  
Inclusion Criteria ◽  
Component Rotation ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> Femoral component rotation in total knee arthroplasty (TKA) is essential for patella-femoral tracking, flexion gap balance and normal kinematic function of the knee. The two referencing techniques used for sizing and adjudging the femoral rotation are anterior referencing (AR) and posterior referencing (PR).The current study was designed so as to identify which referencing system determines the femoral rotation more accurately<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This study involved 34 consecutive patients (22 females and 12 males) with 60 osteoarthritic knees (bilateral=26; unilateral =8) who satisfied the inclusion criteria. The trans-epicondylar axis, was taken as gold standard to adjudge the correct femoral rotation and was marked as E. The axis of rotation as per anterior instrumentation (A), and as per posterior instrumentation (P) were marked and compared as to which of the axis (A or P) was parallel to E.<strong></strong></p><p class="abstract"><strong>Results:</strong> A was always parallel to E, however P was parallel to E in 42 knees. In 18 knees (6 with valgoid deformity, 12 with hypertrophic osteoarthritis involving the medial femoral condyle), P and E tend to converge laterally, suggestive of excessive internal rotation<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Anterior referencing determines femoral rotation more accurately than posterior referencing for knees with severe valgoid deformity or those with hypertrophic osteoarthritis involving the overgrowth of medial femoral condyle<span lang="EN-IN">.</span></p>

A cautionary case: osteoporotic femur fracture after robotic-assisted total knee arthroplasty

2021 ◽  
Author(s):  
H. E. Skibicki ◽  
D. Y. Ponzio ◽  
J. A. Brustein ◽  
Z. D. Post ◽  
A. C. Ong ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femur Fracture ◽  
Robotic Assisted ◽  
Total Knee

An imaging measurement study of normal knee parameters in southeast China

2021 ◽  
Vol 17 ◽  
Author(s):  
Huitong Liu ◽  
Bingqiang Xu ◽  
Eryou Feng ◽  
Shizhang Liu ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Age Groups ◽  
Young Group ◽  
Normal Female ◽  
Valgus Angle ◽  
Significant Difference ◽  
Total Knee

Background: Imaging measurement of distal femur and proximal tibia has been the hot point in the research of total knee arthroplasty and prosthesis development, which is an important treatment for patients with advanced knee joint disease. This study retrospectively investigated the digital imaging measurement of normal knee parameters in southeast China and evaluated their clinical value. Methods: From February 2010 to May 2014, and in accordance with the inclusion criteria, a total of 677 knees (334 female knees and 343 male knees) were categorized into 3 age groups. Clinical and digital imaging data, including the distal femoral condyle diameter (FCD), tibial plateau diameter (TPD), the distance between the medial tibial plateau and fibular head (DPF), tibiofemoral valgus angle, distal femoral valgus angle, proximal tibia (PT) varus angle and the angle from femoral condyle to tibial perpendicular (FT), were measured by using AutoCAD 10.0 software. All measured variables were statistically analyzed by SPSS statistical software (version 18.0). Results: Data are presented as the mean ± standard deviation. The normal female and male femoral condyle diameter was (7.69 ± 0.46) cm and (8.68 ± 0.55) cm, while the normal female and male tibial plateau diameter was (7.66 ± 0.46) cm and (8.60 ± 0.55) cm, respectively. The normal female and male DPF was (0.76 ± 0.36) cm and (0.79 ± 0.36) cm. For females and males, the tibiofemoral valgus angle and distal femoral valgus angle were (3.89 ± 2.20) ° and (3.29 ± 2.12) °, (9.03 ± 2.18) ° and (8.25 ± 2.20) °. As the two methods to measure tibial plateau varus angle, PT angle of normal female and male was (4.29 ± 1.86) ° and (4.84 ± 2.23) °, while the normal female and male FT angle was (5.34 ± 1.95) ° and (5.52 ± 2.07) °. Based on the data obtained, we found significant differences between the two genders in terms of the femoral condyle diameter and tibial plateau diameter in all age groups (P < 0.01). The DPF parameter showed an obvious difference between the young group and the middle-aged group (P < 0.05), and no significant difference was observed between the sides and genders (P > 0.05). The distal femoral valgus angle showed statistical differences between genders in the left side of the young group and middle-aged group (P < 0.05), while angle PT and FT showed no significant difference (P > 0.05). Conclusion: A large number of knee measurements was obtained, and a local knee database was developed in this study. Imaging measurement prior to total knee arthroplasty is clinically important for increasing the accuracy and long-term efficacy of total knee arthroplasty. These data can also provide useful information for knee surgery and sports medicine as well as prosthesis development.

Decreasing Posterior Femoral Condyle Offset Improves Intraoperative Correction of Flexion Contracture in Total Knee Arthroplasty

2020 ◽  
Author(s):  
Murilo Anderson Leie ◽  
Antonio Klasan ◽  
Wei Wang Yeo ◽  
Dylan Misso ◽  
Myles Coolican
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Knee Extension ◽  
Flexion Contracture ◽  
Level Of Evidence ◽  
Full Extension ◽  
Time Of Surgery ◽  
Posterior Femoral Condyle ◽  
Total Knee

AbstractMultiple intraoperative strategies are described to achieve full extension in total knee arthroplasty, but only a few studies have assessed the effect of the flexion gap on intraoperative improvement in flexion contracture. The aim of this study was to determine whether posterior condylar offset, in isolation, independently affects extension at the time of total knee arthroplasty.Two hundred and seventy-eight patients who underwent total knee arthroplasty for knee osteoarthritis and flexion contracture ≥ 5 degrees between January 2008 and July 2018 were included in this study. Patients with other factors that could affect knee extension at the time of surgery were excluded. We recorded the thickness of posterior femoral condyle bone resected as well as the thickness of the posterior femoral component chosen for each patient. Patients' knee extension was recorded under anesthetic, prior to resection and intraoperatively after total knee replacement.Average thickness of bone resection for the posteromedial femur was 12.64  ± 1.65 mm and for the posterolateral femur was 10.38  ± 1.52 mm. Using a linear regression model, we found that changes in posterior offset and implant downsizing influenced correction of fixed flexion deformity at the time of surgery. When patients had a combined posteromedial and posterolateral offset 2 mm thinner than the thickness of bone resected, there was an average correction of 3.5 degrees of flexion contracture.Our study demonstrated that posterior femoral condyle offset is an independent variable affecting correction of flexion contracture at the time of surgery in a gap balanced cruciate-retaining total knee arthroplasty. Level of evidence Level IV evidence

scholarly journals Large osteophyte removal from the posterior femoral condyle significantly improves extension at the time of surgery in a total knee arthroplasty

2020 ◽  
Vol 19 ◽  
pp. 76-83
Author(s):  
Murilo Anderson Leie ◽  
Antonio Klasan ◽  
Takeshi Oshima ◽  
Sven Edwards Putnis ◽  
Wai Weng Yeo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Time Of Surgery ◽  
Posterior Femoral Condyle ◽  
Total Knee

scholarly journals Supracondylar Fracture of the Femur Fracture after Total Knee Arthroplasty.

1991 ◽  
Vol 40 (2) ◽  
pp. 641-644
Author(s):  
Eisuke Shono ◽  
Michiya Hara ◽  
Mituyoshi Kanbara ◽  
Koji Kuroda ◽  
Nahoto Takagishi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femur Fracture ◽  
Supracondylar Fracture ◽  
Total Knee
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