scholarly journals Three-dimensional analysis of the tibial resection plane relative to the arthritic tibial plateau in total knee arthroplasty

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
J. Michael Johnson ◽  
Mohamed R. Mahfouz ◽  
Mehmet Rüştü Midillioğlu ◽  
Alexander J. Nedopil ◽  
Stephen M. Howell
Keyword(s):  
Total Knee Arthroplasty ◽  
Dimensional Analysis ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Three Dimensional ◽  
Tibial Resection ◽  
Total Knee

Low-Degree Tibial Slope Angle Prevents Component Overhang by Enlarging the Lateral Plateau Surface Area in Total Knee Arthroplasty

2020 ◽  
Author(s):  
Mehmet Emin Simsek ◽  
Mustafa Akkaya ◽  
Safa Gursoy ◽  
Özgür Kaya ◽  
Murat Bozkurt
Keyword(s):  
Total Knee Arthroplasty ◽  
Surface Area ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Slope Angle ◽  
Three Dimensional ◽  
Tibial Slope ◽  
Total Knee ◽  
Lateral Plateau ◽  
Gender Groups

AbstractThis study aimed to investigate whether overhang or underhang around the tibial component that occurs during the placement of tibial baseplates was affected by different slope angles of the tibial plateau and determine the changes in the lateral and medial plateau diameters while changing the slope angle in total knee arthroplasty. Three-dimensional tibia models were reconstructed using the computed tomography scans of 120 tibial dry bones. Tibial plateau slope cuts were performed with 9, 7, 5, 3, and 0 degrees of slope angles 2-mm below the subchondral bone in the deepest point of the medial plateau. Total, lateral, and medial tibial plateau areas and overhang/underhang rates were measured at each cut level. Digital implantations of the asymmetric and symmetric tibial baseplates were made on the tibial plateau with each slope angles. Following the implantations, the slope angle that prevents overhang or underhang at the bone border and the slope angle that has more surface area was identified. A significant increase was noted in the total tibial surface area, lateral plateau surface area, and lateral anteroposterior distance, whereas the slope cut angles were changed from 9 to 0 degrees in both gender groups. It was found that the amount of posteromedial underhang and posterolateral overhang increased in both the asymmetric and symmetric tibial baseplates when the slope angle was changed from 0 to 9 degrees. Although the mediolateral diameter did not change after the proximal tibia cuts at different slope angles, the surface area and anteroposterior diameter of the lateral plateau could change, leading to increased lateral plateau area. Although prosthesis designs are highly compatible with the tibial surface area, it should be noted that the component overhangs, especially beyond the posterolateral edge, it can be prevented by changing the slope cut angle in males and females.

scholarly journals Finite-element analysis of the proximal tibial sclerotic bone and different alignment in total knee arthroplasty

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ye-Ran Li ◽  
Yu-Hang Gao ◽  
Chen Yang ◽  
Lu Ding ◽  
Xuebo Zhang ◽  
...  
Keyword(s):  
Finite Element ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Three Dimensional ◽  
Genu Varum ◽  
Sclerotic Bone ◽  
Dimensional Measurements ◽  
Tibial Cut ◽  
Total Knee

Abstract Background Despite potential for improving patient outcomes, studies using three-dimensional measurements to quantify proximal tibial sclerotic bone and its effects on prosthesis stability after total knee arthroplasty (TKA) are lacking. Therefore, this study aimed to determine: (1) the distribution range of tibial sclerotic bone in patients with severe genu varum using three-dimensional measurements, (2) the effect of the proximal tibial sclerotic bone thickness on prosthesis stability according to finite-element modelling of TKA with kinematic alignment (KA), mechanical alignment (MA), and 3° valgus alignment, and (3) the effect of short extension stem augment utilization on prosthesis stability. Methods The sclerotic bone in the medial tibial plateau of 116 patients with severe genu varum was measured and classified according to its position and thickness. Based on these cases, finite-element models were established to simulate 3 different tibial cut alignments with 4 different thicknesses of the sclerotic bone to measure the stress distribution of the tibia and tibial prosthesis, the relative micromotion beneath the stem, and the influence of the short extension stem on stability. Results The distribution range of proximal tibial sclerotic bone was at the anteromedial tibial plateau. The models were divided into four types according to the thickness of the sclerotic bone: 15 mm, 10 mm, 5 mm, and 0 mm. The relative micromotion under maximum stress was smallest after MA with no sclerotic bone (3241 μm) and largest after KA with 15 mm sclerotic bone (4467 μm). Relative micromotion was largest with KA and smallest with MA in sclerotic models with the same thickness. Relative micromotion increased as thickness of the sclerotic bone increased with KA and MA (R = 0.937, P = 0.03 and R = 0.756, P = 0.07, respectively). Relative micromotion decreased with short extension stem augment in the KA model when there was proximal tibial sclerotic bone. Conclusions The influence of proximal tibial sclerotic bone on prosthesis’s stability is significant, especially with KA tibial cut. Tibial component’s short extension stem augment can improve stability.

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

Three-dimensional analysis of image-free navigation system for total knee arthroplasty

2010 ◽  
Vol 95 (2) ◽  
pp. 81-87 ◽  
Author(s):  
D. Tigani ◽  
E. Rimondi ◽  
P. Trentani ◽  
M. Ansaloni ◽  
L. Amendola ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Dimensional Analysis ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Three Dimensional ◽  
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.

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