scholarly journals New option of tibial plateau plasty in total knee arthroplasty

2021 ◽  
Vol 27 (5) ◽  
pp. 592-596
Author(s):  
I.F. Akhtyamov ◽  
◽  
I.Sh. Gilmutdinov ◽  
E.R. Khasanov ◽  
◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Tibial Plateau ◽  
Proximal Tibia ◽  
Weight Bearing ◽  
Cement Augmentation ◽  
Early Weight Bearing ◽  
Regular Triangle ◽  
Total Knee

Abstract. Introduction There are several options of fixation and plasty for tibial defects. Screw and cement augmentation of the tibia is an alternative to conventional bone autograft and allograft. Although use of metal and cement augments provides reliable support for the tibial plateau and facilitates early weight-bearing on the operated limb the technique fails to maintain enough bone stock for future revisions. The purpose was to present an option of cement and metal augmentation of the tibial component in total knee arthroplasty (TKA). Material and methods The technique consists of cement and screw augmentation using three screws placed vertically as a regular triangle and being perpendicular to the tibial plateau. We describe the technique and a clinical instance of type 2A defect of the proximal tibia using the author's method. Outcome measures were goniometry and radiography. Results Goniometry examination showed positive dynamics in the first week after surgery with flexion of 110.0 degrees, extension 175.0 degrees; at 12 months with flexion of 90.0 degrees and extension of 180.0 degrees. Radiographic examination demonstrated no instability and micromobility of the cement mantle. Discussion The author's technique of screw and cement augmentation of the tibial component was practical for type 2A defects of the proximal tibia with a shortage of materials of bone autografts. This is a pilot study that requires further investigations.

The Effect of Early Weight-bearing in Total Knee Arthroplasty

1986 ◽  
Vol &NA; (207) ◽  
pp. 178???185
Author(s):  
DAVID L. GRACE ◽  
ANDREA CRACCHIOLO ◽  
FREDERICK J. DOREY
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Weight Bearing ◽  
Early Weight Bearing ◽  
Total Knee

Morphometry of the proximal tibia to design the tibial component of total knee arthroplasty for the Korean population

The Knee ◽  
2007 ◽  
Vol 14 (4) ◽  
pp. 295-300 ◽  
Author(s):  
Dai Soon Kwak ◽  
Sibin Surendran ◽  
Yassir Hussain Pengatteeri ◽  
Sang Eun Park ◽  
Kwang Nam Choi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Proximal Tibia ◽  
Korean Population ◽  
Total Knee

Comparison of intraoperative anthropometric measurements of the proximal tibia and tibial component in total knee arthroplasty

2016 ◽  
Vol 21 (5) ◽  
pp. 635-639
Author(s):  
Naohisa Miyatake ◽  
Takehiko Sugita ◽  
Toshimi Aizawa ◽  
Akira Sasaki ◽  
Ikuo Maeda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Proximal Tibia ◽  
Anthropometric Measurements ◽  
Total Knee

Primary Total knee Arthroplasty: A Viable Surgical Option for Complex Tibial Plateau Fractures in Elderly

2019 ◽  
Vol 33 (05) ◽  
pp. 496-503 ◽  
Author(s):  
Ahmed Abdelbadie ◽  
Ayman El-Hennawy ◽  
Asser Sallam
Keyword(s):  
Total Knee Arthroplasty ◽  
Elderly Patients ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Weight Bearing ◽  
Primary Total Knee Arthroplasty ◽  
Tibial Plateau Fractures ◽  
Full Weight Bearing ◽  
Total Knee ◽  
Primary Total Knee

AbstractThe optimal treatment of complex tibial plateau fractures in elderly is still controversial. The aim of the study was to retrospectively analyze the clinical and radiological outcomes of primary total knee arthroplasty (TKA) versus open reduction and internal fixation (ORIF) in elderly patients presenting with acute complex tibial plateau fractures. Between June 2011 and December 2015, we have analyzed the clinical outcomes of 22 primary total knee replacements and 21 ORIFs. The mean follow-up was 27 months. The intra- and postoperative complications, as well as the knee society score (KSS), were our outcome measures. The knee range of motion and the KSS knee and function scores were significantly better in the TKA patients compared with ORIF patients. Early postoperative full weight-bearing was allowed in the TKA patients with lower complications rate. In conclusion, primary TKA utilizing a stemmed tibial component is an effective treatment option for elderly patients with a complex acute fracture of the tibial plateau. This is a Type III therapeutic study.

Rotational alignment of the tibial component affects the kinematic rotation of a weight-bearing knee after total knee arthroplasty

The Knee ◽  
2015 ◽  
Vol 22 (3) ◽  
pp. 201-205 ◽  
Author(s):  
Hiroyuki Nakahara ◽  
Ken Okazaki ◽  
Satoshi Hamai ◽  
Shinya Kawahara ◽  
Hidehiko Higaki ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Weight Bearing ◽  
Rotational Alignment ◽  
Total Knee

Intraoperative Proximal Tibia Periprosthetic Fractures in Primary Total Knee Arthroplasty

2020 ◽  
Author(s):  
Christopher W. Damsgaard ◽  
Bishoy V. Gad ◽  
Olivia J. Bono ◽  
Marie C. Anderson ◽  
Jonathon M. Brown ◽  
...  
Keyword(s):  
Risk Factors ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Rare Complication ◽  
Weight Bearing ◽  
Control Group ◽  
Polyethylene Insert ◽  
Tibia Fractures ◽  
Total Knee

AbstractIntraoperative fracture of the proximal tibia is a rare complication of total knee arthroplasty (TKA) with few studies available reporting risk factors or prognosis. A review of our prospective joint registry was performed to determine the incidence and associated risk factors of intraoperative tibia fractures during primary TKA; 14,966 TKAs of all manufacturers were performed with 9 intraoperative tibia fractures. All fractures occurred in a single TKA design. There were 8,155 TKAs of this design performed with a fracture incidence of 0.110%. All but one fracture occurred on the medial tibial plateau, and all but one occurred during preparation of the tibia with keel punching. A control group of 75 patients (80 knees) with the same TKA design were randomly selected. Baseplates size 3 or smaller were less likely to experience an intraoperative fracture (odds ratio [OR]: 0.864, 95% confidence interval [CI]: 0.785–0.951), as were knees with a polyethylene insert thickness of 13 mm or larger (OR: 0.882, 95% CI: 0.812–0.957). Fractures were treated with a variety of different methods, but every patient had at least one screw placed and most (67%) had postoperative weight-bearing restrictions. At final follow-up, there were no cases of nonunion, component subsidence, or need for reoperation. Intraoperative tibia fractures are a rare complication of this TKA design at 0.11%. Knees with baseplates of size ≤3 and polyethylene thickness ≥13 mm were less likely to experience intraoperative fracture. These findings may be related to the depth of tibial resection, requiring the use of a thicker polyethylene insert, and a change in the keel width in implants size 4 or larger. No fracture patients required reoperation.

scholarly journals Unusually High Rate of Early Failure of Tibial Component in ATTUNE Total Knee Arthroplasty System at Implant–Cement Interface

2017 ◽  
Vol 30 (05) ◽  
pp. 435-439 ◽  
Author(s):  
Anton Khlopas ◽  
Morad Chughtai ◽  
Connor Cole ◽  
Chukwuweike Gwam ◽  
Steven Harwin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Rare Complication ◽  
Weight Bearing ◽  
High Rate ◽  
Radiographic Evaluation ◽  
Rotating Platform ◽  
Cement Interface ◽  
Total Knee

AbstractA novel design total knee arthroplasty (TKA) system has been introduced to improve patient outcomes and increase longevity. However, we have encountered a high rate of debonding of tibial implant–cement interface. In addition, multiple reports have been filed in Manufacturer and User Facility Device Experience database (MAUDE) with the same mechanism of failure. Therefore, we evaluated: clinical, radiographic, and intraoperative findings of patients who received this system and required a revision surgery, and findings from MAUDE database compiled to this date. We reviewed three hospital databases for patients who had revision TKA for tibial loosening at the implant–cement interface. This yielded 15 cases with a mean age of 61 years (range, 47–84). All patients received a novel knee system at another institution. Radiographic analysis was performed by treating orthopaedist. The MAUDE database was reviewed for reports of aseptic failure. Patients presented with pain on weight bearing, effusion, and decreased range of motion (ROM) within 2 years after surgery. Radiographic evaluation demonstrated loosening of the tibial components in 2 of 15 knees. This included cruciate retaining, posterior stabilized, fixed bearing, and rotating platform bearing designs. Intraoperative findings demonstrated gross loosening of the tibial component at the implant–cement interface. Femoral and patellar components were well fixed. There were 21 reports of tibial loosening at the implant–cement interface in MAUDE database in the past 2 months alone. Numerous other tibial failures were reported; however, the mechanisms of failures were not specified. Tibial component loosening is a rare complication of cemented TKA at short-term follow-up. Several possible reasons include increased constraint, reduced cement pockets, and reduced keel rotational stabilizers. The tibial component, which has greater torsional loads, has lower surface roughness than femoral component. We believe that this complication is underreported due to failure of radiographs to assess loosening. In addition, MAUDE database reporting is not consistent and competing companies cannot provide data on the revised components. In patients who have negative workup for a painful joint, one must consider the diagnosis of debonding.

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