scholarly journals Effect of sagittal femoral component alignment on biomechanics after mobile-bearing total knee arthroplasty

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yong-Gon Koh ◽  
Jin-Ah Lee ◽  
Hwa-Yong Lee ◽  
Dong-Suk Suh ◽  
Hyo-Jeong Kim ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Sagittal Alignment ◽  
Mobile Bearing ◽  
Component Alignment ◽  
Collateral Ligament ◽  
Joint Contact ◽  
Total Knee ◽  
Quadriceps Force ◽  
Biomechanical Effect

Abstract Background Recently, there has been increasing interest in mobile-bearing total knee arthroplasty (TKA). However, changes in biomechanics with respect to femoral component alignment in mobile-bearing TKA have not been explored in depth. This study aims to evaluate the biomechanical effect of sagittal alignment of the femoral component in mobile-bearing TKA. Methods We developed femoral sagittal alignment models with − 3°, 0°, 3°, 5°, and 7°. We also examined the kinematics of the tibiofemoral (TF) joint, contact point on the TF joint, contact stress on the patellofemoral (PF) joint, collateral ligament force, and quadriceps force using a validated computational model under a deep-knee-bend condition. Results Posterior kinematics of the TF joint increased as the femoral component flexed. In addition, contact stress on the PF joint, collateral ligament force, and quadriceps force decreased as the femoral component flexed. The results of this study can assist surgeons in assessing risk factors associated with femoral component sagittal alignment for mobile-bearing TKA. Conclusions Our results showed that slight flexion implantation may be an effective alternative technique because of its advantageous biomechanical effect. However, excessive flexion should be avoided because of potential loosening of the TF joint.

scholarly journals Retraction Note: Effect of sagittal femoral component alignment on biomechanics after mobile-bearing total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong-Gon Koh ◽  
Jin-Ah Lee ◽  
Hwa-Yong Lee ◽  
Dong-Suk Suh ◽  
Hyo-Jeong Kim ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Mobile Bearing ◽  
Component Alignment ◽  
Total Knee ◽  
Retraction Notice

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13018-019-1458-5.

Navigation-Assisted Total Knee Arthroplasty for a Valgus Knee Improves Limb and Femoral Component Alignment

Orthopedics ◽  
2019 ◽  
Vol 42 (2) ◽  
pp. e253-e259 ◽  
Author(s):  
Sung-Sahn Lee ◽  
Kyeu-Back Kwon ◽  
Yong-In Lee ◽  
Young-Wan Moon
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Valgus Knee ◽  
Component Alignment ◽  
Total Knee

Variation in Optimal Sagittal Alignment of the Femoral Component in Total Knee Arthroplasty

Orthopedics ◽  
2016 ◽  
Vol 40 (2) ◽  
pp. 102-106 ◽  
Author(s):  
Brandon Hood ◽  
Laura Blum ◽  
Sven A. Holcombe ◽  
Stewart C. Wang ◽  
Andrew G. Urquhart ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Sagittal Alignment ◽  
Total Knee

A Flexible Intramedullary Guide Can Reduce the Anteroposterior Oversizing of Femoral Components Used in Total Knee Arthroplasty in Patients with Osteoarthritis and Severe Distal Femoral Sagittal Bowing

2021 ◽  
Author(s):  
Do Weon Lee ◽  
Joonhee Lee ◽  
Junpyo Lee ◽  
Du Hyun Ro ◽  
Myung Chul Lee ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Sagittal Alignment ◽  
Primary Tkas ◽  
Functional Scores ◽  
Total Knee ◽  
Intramedullary Rod ◽  
Rigid Rod

AbstractTraditionally, a rigid intramedullary rod has been used as the reference guide for femoral cutting in total knee arthroplasty (TKA). However, correct positioning of this rigid rod is difficult, especially in the knees with severe distal femoral sagittal bowing. A flexible intramedullary rod has been developed to address this problem. This study was performed to compare the sagittal alignment and clinical outcomes of TKAs performed with flexible and rigid femoral intramedullary guides. Thirty-eight knees that underwent primary TKAs with flexible intramedullary rods as femoral cutting guides were matched according to patient height and sex with 38 knees that underwent TKAs using conventional rigid rods. Clinical outcomes, including the range of motion and functional scores, and radiological variables, including the distal femoral bowing angle (DFBA), femoral component flexion angle (FFA), and mediolateral overhang and anteroposterior (AP) oversizing of femoral components, were evaluated. Clinical and radiological outcomes did not differ significantly between the flexible rod and conventional rigid rod groups. A subgroup analysis of knees with severe distal femoral sagittal bowing (DFBA >4 degrees) showed that the FFA was significantly larger in the flexible rod group than in the rigid rod group, with an average difference of 3 degrees (5.2 ± 2.4 vs. 2.2 ± 1.6 degrees, respectively, p = 0.022). In addition, the incidence of AP oversizing of femoral components was lower in the flexible rod group than in the rigid rod group (11.1 vs. 60.0%, respectively, p = 0.027). Relative to TKA with a rigid rod, TKA performed with a flexible femoral intramedullary guide resulted in more flexed sagittal alignment of femoral components in patients with severe distal femoral sagittal bowing. This greater flexion of the femoral component resulted in less AP oversizing. However, the use of a flexible rod had no impact on short-term clinical outcomes.

Excessive flexed position of the femoral component was associated with poor new Knee Society Score after total knee arthroplasty with the Bi-Surface knee prosthesis

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 36-42
Author(s):  
Kohei Nishitani ◽  
Shinichi Kuriyama ◽  
Shinichiro Nakamura ◽  
Naoki Umatani ◽  
Hiromu Ito ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Knee Society Score ◽  
Sagittal Alignment ◽  
Knee Prosthesis ◽  
Rear Surface ◽  
Functional Activities ◽  
Total Knee

Aims This study aimed to evaluate the association between the sagittal alignment of the femoral component in total knee arthroplasty (TKA) and new Knee Society Score (2011KSS), under the hypothesis that outliers such as the excessive extended or flexed femoral component were related to worse clinical outcomes. Methods A group of 156 knees (134 F:22 M) in 133 patients with a mean age 75.8 years (SD 6.4) who underwent TKA with the cruciate-substituting Bi-Surface Knee prosthesis were retrospectively enrolled. On lateral radiographs, γ angle (the angle between the distal femoral axis and the line perpendicular to the distal rear surface of the femoral component) was measured, and the patients were divided into four groups according to the γ angle. The 2011KSSs among groups were compared using the Kruskal-Wallis test. A secondary regression analysis was used to investigate the association between the 2011KSS and γ angle. Results According to the mean and SD of γ angle (γ, 4.0 SD 3.0°), four groups (Extended or minor flexed group, −0.5° ≤ γ < 2.5° (n = 54)), Mild flexed group (2.5° ≤ γ < 5.5° (n = 63)), Moderate flexed group (5.5° ≤ γ < 8.5° (n = 26)), and Excessive flexed group (8.5° ≤ γ (n = 13)) were defined. The Excessive flexed group showed worse 2011KSSs in all subdomains (Symptoms, Satisfaction, Expectations, and Functional activities) than the Mild flexed group. Secondary regression showed a convex upward function, and the scores were highest at γ = 3.0°, 4.0°, and 3.0° in Satisfaction, Expectations, and Functional activities, respectively. Conclusion The groups with a sagittal alignment of the femoral component > 8.5° showed inferior clinical outcomes in 2011KSSs. Secondary regression analyses showed that mild flexion of the femoral component was associated with the highest score. When implanting the Bi-Surface Knee prosthesis surgeons should pay careful attention to avoiding flexing the femoral component extensively during TKA. Our findings may be applicable to other implant designs. Cite this article: Bone Joint J 2020;102-B(6 Supple A):36–42.

scholarly journals The unicompartmental knee is the preferred side in individuals with both a unicompartmental and total knee arthroplasty

2019 ◽  
Vol 28 (10) ◽  
pp. 3193-3199 ◽  
Author(s):  
Anatole Vilhelm Wiik ◽  
Dinesh Nathwani ◽  
Ahsan Akhtar ◽  
Bilal Al-Obaidi ◽  
Robin Strachan ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Sagittal Plane ◽  
Coronal Alignment ◽  
Component Alignment ◽  
Posterior Slope ◽  
Knee Oa ◽  
Unicompartmental Knee ◽  
Total Knee

Abstract Purpose To determine the preferred knee in patients with both one total and one unicompartmental knee arthroplasty. Method Patients simply with a unicompartmental (UKA) and total knee arthroplasty (TKA) on contralateral sides were retrospectively screened from three senior knee surgeon’s logs over a 15 year period. Patients safe and free from other diseases to affect gait were approached. A total of 16 patients (mean age 70 ± 8) agreed to ground reaction force testing on an instrumented treadmill at a fair pace and incline. A gender-ratio identical group of 16 healthy control subjects (mean age 67 ± 10) and 16 patients with ipsilateral medial knee OA (mean age 66 ± 7) were analysed to compare. Results Radiographically the mode preoperative Kellgren–Lawrence knee grade for each side was 3. Postoperatively, the TKA side had a mean coronal femoral component alignment of 7° and a mean tibial coronal alignment of 89° with a mean posterior slope of 5° in the sagittal plane. The UKA side had a mean coronal femoral component alignment of 7° and a mean tibial coronal alignment of 86° with a mean posterior slope of 4° in the sagittal plane. In 7 patients, the TKA was the first procedure, while 6 for the UKA and 3 done simultaneously. Gait analysis demonstrated in both walking conditions the UKA limb was the preferred side through all phases of loading (p < 0.05) and nearer to normal than the TKA limb when compared to healthy controls and patients with knee OA. The greatest difference was observed between the transition of weight acceptance and midstance (p = 0.008), when 22% more load was taken by the UKA side. Conclusion By using a dynamic metric of an everyday activity, a distinct gait difference between differing arthroplasty types were established. A more natural loading pattern can be achieved with unicompartmentals as compared to total knees. Level of evidence Retrospective comparative study, Level III.

Sign in / Sign up

Export Citation Format

Share Document