scholarly journals Range of Motion Comparison Following Total Knee Arthroplasty with and without Patella Resurfacing

2021 ◽  
Vol 11 ◽  
Author(s):  
Melissa Jackels ◽  
Samantha Andrews ◽  
Maya Matsumoto ◽  
Kristin Mathews ◽  
Cass Nakasone
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Extension ◽  
Implant Design ◽  
Tourniquet Time ◽  
Full Extension ◽  
Total Knee ◽  
Low Incidence

Background: Despite significant evaluation, no consensus has been reach for best clinical practice for resurfacing the patella during total knee arthroplasty. Further complicating the ability to reach a conclusion is the inclusion of several different implant types used in previous research. Questions/Purpose: The purpose of this study was to compare post-TKA outcomes between two cruciate retaining implants with or without patella resurfacing. Methods: This retrospective review included 289 patients (380 knees) with a minimum six-month follow-up. All patients received a CR implant, with either a symmetric or an asymmetric tibial baseplate. Post-TKA knee flexion was categorized as <120° and ≥120° and knee extension classified as 0° or >0° and required knee manipulations were noted. Descriptive, nonparametric statistics were performed and a multivariate logistic regression was performed to determine risk of poor range of motion and manipulations. Results: Age was significantly lower in the resurfaced group (p=0.001) and the resurfaced group had longer tourniquet time (p=0.003). The symmetric-resurfaced group had ≥120° of flexion and full extension in 72% and 98.7% of patients, respectively. Compared to symmetric-resurfaced, all other groups had a significantly greater risk of not reaching 120° of knee flexion (p<0.05). There were no significant differences in the risk of requiring a MUA between groups (p>0.06). Conclusions: The effect of resurfacing the patella on post-TKA outcomes may be influenced by tibial implant design. Compared to all other combinations, a symmetric tibial baseplate and resurfaced patella resulted in the highest percentage of patients reaching ≥120°, with a low incidence of manipulations.

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 Knee Flexion after Total Knee Arthroplasty

2007 ◽  
Vol 15 (2) ◽  
pp. 149-153 ◽  
Author(s):  
PH Li ◽  
YC Wong ◽  
YL Wai
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Female Gender ◽  
Implant Design ◽  
Functional Score ◽  
Middle Range ◽  
Postoperative Flexion ◽  
Total Knee ◽  
Flexion And Extension

Purpose. To identify factors related to knee flexion after total knee arthroplasty in a Chinese population. Methods. Records of 242 total knee arthroplasties were retrospectively reviewed. The parameters evaluated were age, gender, diagnosis, preoperative knee flexion and extension, preoperative flexion arc, tibiofemoral angle, Knee Society knee score and functional score, and implant design. Results. Advanced age, female gender, and good preoperative flexion and flexion arc were related to better postoperative flexion. Postoperative flexion tended to migrate to the middle range despite different ranges of preoperative flexion. Preoperative tibiofemoral malalignment had no significant effect on postoperative flexion. Conclusion. Contemporary designs of posterior stabilised prostheses with right and left femoral components were superior to older designs.

scholarly journals Importance of knee flexion range of motion during the acute phase after total knee arthroplasty

2020 ◽  
Vol 23 (2) ◽  
pp. 143-148
Author(s):  
Tomohiro OKA ◽  
Osamu WADA ◽  
Tsuyoshi ASAI ◽  
Hideto MARUNO ◽  
Kiyonori MIZUNO
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Acute Phase ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Total Knee

A Simple Goniometer for Use Intra-Operatively in Total Knee Arthroplasty

2010 ◽  
Author(s):  
Kate D. Liddle ◽  
Jennifer Peter ◽  
Jovauna M. Currey ◽  
Jenni M. Buckley ◽  
William A. McGann
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Computer Assisted Surgery ◽  
Cost Effective ◽  
Knee Extension ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Important Indicator ◽  
Total Knee

Intra-operative range of motion (ROM) assessment can be challenging during total knee arthroplasty (TKA) surgery. Measurement accuracy is often compromised by patient draping and anatomy, particularly when assessing knee extension. Accurate ROM assessment is important, as ROM after total knee arthroplasty is an important indicator of clinical outcome. Computer assisted surgery has been shown to accurately determine intra-operative range of motion; however, navigation systems are costly and not readily available to many surgeons. We have developed a simple, cost-effective intraoperative device to precisely measure knee flexion and extension that is efficient and easy to use.

scholarly journals Knee-Extension Training with a Single-Joint Hybrid Assistive Limb during the Early Postoperative Period after Total Knee Arthroplasty in a Patient with Osteoarthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomokazu Yoshioka ◽  
Hisashi Sugaya ◽  
Shigeki Kubota ◽  
Mio Onishi ◽  
Akihiro Kanamori ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Knee Extensor ◽  
Recovery Phase ◽  
Knee Extension ◽  
Early Postoperative Period ◽  
Wearable Robot ◽  
Total Knee ◽  
Hybrid Assistive Limb

The knee range of motion is an important outcome of total knee arthroplasty (TKA). According to previous studies, the knee range of motion temporarily decreases for approximately 1 month after TKA due to postoperative pain and quadriceps dysfunction following surgical invasion into the knee extensor mechanism. We describe our experience with a knee-extension training program based on a single-joint hybrid assistive limb (HAL-SJ, Cyberdyne Inc., Tsukuba, Japan) during the acute recovery phase after TKA. HAL-SJ is a wearable robot suit that facilitates the voluntary control of knee joint motion. A 76-year-old man underwent HAL-SJ-based knee-extension training, which enabled him to perform knee function training during the acute phase after TKA without causing increased pain. Thus, he regained the ability to fully extend his knee postoperatively. HAL-SJ-based knee-extension training can be used as a novel post-TKA rehabilitation modality.

scholarly journals Component gap control during posterior-stabilised total knee arthroplasty using the posterior condylar pre-cut technique

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Makoto Kawasaki ◽  
Ryutaku Kaneyama ◽  
Hitoshi Suzuki ◽  
Teruaki Fujitani ◽  
Manabu Tsukamoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Femoral Condyle ◽  
Posterior Part ◽  
Case Series ◽  
Knee Extension ◽  
Level Of Evidence ◽  
Gap Control ◽  
Total Knee

Abstract Purpose Adjusting the gap lengths to ensure equal lengths in both extension and flexion during total knee arthroplasty (TKA) is important for achieving successful outcomes. We designed a new pre-cut trial component (PCT) for posterior-stabilised (PS) TKA and aimed to determine whether the pre-cut technique is useful for component gap (CG) control in PS TKA. Methods A total of 70 knees were included. The PS PCT for PS TKA is composed of a 9-mm-thick distal part and 5-mm-thick posterior part with a cam structure. First, the distal femur and proximal tibia were cut to create an extension gap. Next, a 4-mm pre-cut was made from the posterior femoral condylar line; then, the PS PCT was attached, and the CGs were checked and compared at 0° and 90° knee flexion. Final CGs with the trial femoral components were compared with gaps in PS PCT at 0° and 90° knee flexion. Results CGs using PS PCTs were 10.2 mm at 0° and 13.6 mm at 90° knee flexion. According to the release of the posterior capsule at intercondylar notch and the adjustment of the cutting level of posterior femoral condyle, the final CG on knee extension was 11.3 mm; it did not significantly differ from CGs with PS PCT. The final CG at 90° knee flexion was 12.7 mm; it did not significantly differ from the estimated gap (12.4 mm) in PS PCT after flexion gap control. Conclusion CG control using PS PCT is a useful technique during PS TKA. Level of evidence Level IV: Case series.

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