scholarly journals The revision partial knee classification system: understanding the causative pathology and magnitude of further surgery following partial knee arthroplasty

2021 ◽  
Vol 2 (8) ◽  
pp. 638-645
Author(s):  
Amy J. Garner ◽  
Thomas C. Edwards ◽  
Alexander D. Liddle ◽  
Gareth G. Jones ◽  
Justin P. Cobb
Keyword(s):  
Health Economics ◽  
Knee Arthroplasty ◽  
Classification System ◽  
Knee Prosthesis ◽  
Rater Reliability ◽  
Partial Knee Arthroplasty ◽  
Consensus Group ◽  
Interclass Correlation ◽  
Total Knee ◽  
Kendall’S W

Aims Joint registries classify all further arthroplasty procedures to a knee with an existing partial arthroplasty as revision surgery, regardless of the actual procedure performed. Relatively minor procedures, including bearing exchanges, are classified in the same way as major operations requiring augments and stems. A new classification system is proposed to acknowledge and describe the detail of these procedures, which has implications for risk, recovery, and health economics. Methods Classification categories were proposed by a surgical consensus group, then ranked by patients, according to perceived invasiveness and implications for recovery. In round one, 26 revision cases were classified by the consensus group. Results were tested for inter-rater reliability. In round two, four additional cases were added for clarity. Round three repeated the survey one month later, subject to inter- and intrarater reliability testing. In round four, five additional expert partial knee arthroplasty surgeons were asked to classify the 30 cases according to the proposed revision partial knee classification (RPKC) system. Results Four classes were proposed: PR1, where no bone-implant interfaces are affected; PR2, where surgery does not include conversion to total knee arthroplasty, for example, a second partial arthroplasty to a native compartment; PR3, when a standard primary total knee prosthesis is used; and PR4 when revision components are necessary. Round one resulted in 92% inter-rater agreement (Kendall’s W 0.97; p < 0.005), rising to 93% in round two (Kendall’s W 0.98; p < 0.001). Round three demonstrated 97% agreement (Kendall’s W 0.98; p < 0.001), with high intra-rater reliability (interclass correlation coefficient (ICC) 0.99; 95% confidence interval 0.98 to 0.99). Round four resulted in 80% agreement (Kendall’s W 0.92; p < 0.001). Conclusion The RPKC system accounts for all procedures which may be appropriate following partial knee arthroplasty. It has been shown to be reliable, repeatable and pragmatic. The implications for patient care and health economics are discussed. Cite this article: Bone Jt Open 2021;2(8):638–645.

Total knee arthroplasty using the total condylar III knee prosthesis

1991 ◽  
Vol 6 (4) ◽  
pp. 341-350 ◽  
Author(s):  
Areesak L. Chotivichit ◽  
Andrea Cracchiolo ◽  
Gregory H. Chow ◽  
Frederick Dorey
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Total Knee

The effect of knee prosthesis design on tibiofemoral biomechanics during extension tasks following total knee arthroplasty

The Knee ◽  
2019 ◽  
Vol 26 (5) ◽  
pp. 1010-1019
Author(s):  
Aaron Beach ◽  
Gianmarco Regazzola ◽  
Thomas Neri ◽  
Richard Verheul ◽  
David Parker
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Prosthesis Design ◽  
Total Knee

scholarly journals A Wireless Visualized Sensing System with Prosthesis Pose Reconstruction for Total Knee Arthroplasty

Sensors ◽  
2019 ◽  
Vol 19 (13) ◽  
pp. 2909 ◽  
Author(s):  
Hanjun Jiang ◽  
Shaolin Xiang ◽  
Yanshu Guo ◽  
Zhihua Wang
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Image Data ◽  
Force Balance ◽  
Prototype System ◽  
Sensing System ◽  
Flexion Extension ◽  
Total Knee

The surgery quality of the total knee arthroplasty (TKA) depends on how accurate the knee prosthesis is implanted. The knee prosthesis is composed of the femoral component, the plastic spacer and the tibia component. The instant and kinetic relative pose of the knee prosthesis is one key aspect for the surgery quality evaluation. In this work, a wireless visualized sensing system with the instant and kinetic prosthesis pose reconstruction has been proposed and implemented. The system consists of a multimodal sensing device, a wireless data receiver and a data processing workstation. The sensing device has the identical shape and size as the spacer. During the surgery, the sensing device temporarily replaces the spacer and captures the images and the contact force distribution inside the knee joint prosthesis. It is connected to the external data receiver wirelessly through a 432 MHz data link, and the data is then sent to the workstation for processing. The signal processing method to analyze the instant and kinetic prosthesis pose from the image data has been investigated. Experiments on the prototype system show that the absolute reconstruction errors of the flexion-extension rotation angle (the pitch rotation of the femoral component around the horizontal long axis of the spacer), the internal–external rotation (the yaw rotation of the femoral component around the spacer vertical axis) and the mediolateral translation displacement between the centers of the femoral component and the spacer based on the image data are less than 1.73°, 1.08° and 1.55 mm, respectively. It provides a force balance measurement with error less than ±5 N. The experiments also show that kinetic pose reconstruction can be used to detect the surgery defection that cannot be detected by the force measurement or instant pose reconstruction.

scholarly journals Result of posteromedial capsule and superficial medial collateral ligament release on gap and alignment in total knee arthroplasty in varusknee deformity by computer assisted surgery measurement: a retrospective stud

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0006
Author(s):  
Pruk Chaiyakit ◽  
Ittiwat Onklin ◽  
Weeranate Ampunpong
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Prosthesis ◽  
Computer Assisted Surgery ◽  
Varus Deformity ◽  
Flexion Contracture ◽  
Computer Assisted ◽  
Total Knee ◽  
The Mean ◽  
Lateral Gaps

Soft tissue release and gap balancing in total knee arthroplasty (TKA) are important issue and lack of conclusive result. We performed posteromedial capsule (PMC) and superficial medial collateral ligament (sMCL) release by preservation of anterior attachment of pes anserine. Gaps and alignment were recorded by computer assisted surgery measurement. Results: T: The mean correction of varus deformity after PMC release and sMCL release were 4.88 ± 2.82° and 3.39 ± 1.7 respectively with the mean FC after PMC and sMCL release correction of 5.57 ± 3.5 and 1.34 ± 2.9° respectively. The mean medial gap changes on full extension after PMC and sMCL release was 1.83 ± 1.39 and 1.67 ± 1.04 mm. respectively with the mean medial gaps at 90 degree flexion after PMC and sMCL release changes of 0.73 ± 0.9 and 5.14 ± 2.11 mm. respectively. The mean lateral gap changes on extension after PMC and sMCL release were -1.3 ± 1.83 and -1.1 ± 1.6 mm. respectively with the mean lateral gaps at 90 degree flexion after PMC and sMCL release changes of -0.19 ± 1.03 and 0.06 ± 1.75 mm. here were 21 patients (16 female and 5 male) with mean age of 68 (48-78) years. The mean body mass index was 28.49 (20.70 – 39.95) kg/m2. The mean preoperative hip-knee-ankle angle was varus 8.12 (3.5-16.0) degrees with mean flexion contracture of 11.3 (3.5-16.0) degrees. Sixteen knees were implanted with Fixed bearing knee prosthesis and five knees were implanted with Mobile bearing knee prosthesis (Table.1). We performed PMC release in all patients, and combined PMC and sMCL release in fourteen patients. The mean correction of varus deformity after PM release and sMCL release were 4.88 ± 2.82 and 3.39 ± 1.7 degrees respectively. While the mean correction of flexion contracture after PMC release and sMCL release were 5.57 ± 3.5 and 1.34 ± 2.9 degrees respectively (Fig.8). The mean medial gaps change on extension after PMC and sMCL release were 1.83 ± 1.39 and 1.67 ± 1.04 mm. respectively. The mean medial gaps change at 90 degree flexion after PMC and sMCL release were 0.73 ± 0.9 and 5.14 ± 2.11 mm. respectively (Fig.9). The mean lateral gaps change on extension after PMC and sMCL release were 1.3 ± 1.83 and -1.1 ± 1.6 mm. respectively. The mean lateral gaps change at 90 degree flexion after PMC and sMCL release were -0.19 ± 1.03 and 0.06 ± 1.75 mm. (Fig.9). There is no instability of knee after PMC and sMCL release. Materials and Methods: Twenty one patient had been operated on. TKA with computer assisted surgery was performed using PMC and sMCL release by preservation of anterior attachment of pes anserine. Alignment, medial and lateral gaps were measured by computer assisted surgery. The mean age was 68 (48-78) years with the mean preoperative hip-kneeankle angle of 8.12 (3.5-16.0) degrees and the mean flexion contracture (FC) of 11.3 (3.516.0) degrees. Conclusion: We believe that sMCL release with preservation of anterior attachment of pes anserinus in total knee arthroplasty has additional effect on varus knee correction after PMC release without creation of knee instability.

Intra and Inter-Rater Reliability of brief balance Evaluation system test in Patients with total Knee Arthroplasty

2018 ◽  
Vol 12 (1) ◽  
pp. 144
Author(s):  
B Mital Shah ◽  
A Thangamani Ramalingam ◽  
D Bid Dibyendunarayan ◽  
Patel KeniK ◽  
S Patel Krishna ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Evaluation System ◽  
Rater Reliability ◽  
Total Knee
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