scholarly journals Primary osteosynthesis augmented with autologous bone graft with total knee arthroplasty in patients with stress fractures of medial femoral condyle with knee osteoarthritis: a cost effective approach

2016 ◽  
pp. 2408-2412
Author(s):  
Vikram Shah ◽  
Kalpesh Shah ◽  
Sachin Upadhyay
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Femoral Condyle ◽  
Cost Effective ◽  
Autologous Bone Graft ◽  
Medial Femoral Condyle ◽  
Cost Effective Approach ◽  
Total Knee ◽  
Autologous Bone ◽  
Primary Osteosynthesis

scholarly journals The Bony Resection Accuracy with Patient-Specific Instruments during Total Knee Arthroplasty: A Retrospective Case Series Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Liang Yuan ◽  
Bin Yang ◽  
Xiaohua Wang ◽  
Bin Sun ◽  
Ke Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Plateau ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Patient Specific ◽  
Lateral Tibial Plateau ◽  
Bone Resection ◽  
Total Knee

Purpose. Bony resection is the primary step during total knee arthroplasty. The accuracy of bony resection was highly addressed because it was deemed to have a good relationship with mechanical line. Patient-specific instruments (PSI) were invented to copy the bony resection references from the preoperative surgical plan during a total knee arthroplasty (TKA); however, the accuracy still remains controversial. This study was aimed at finding out the accuracy of the bony resection during PSI-assisted TKA. Methods. Forty-two PSI-assisted TKAs (based on full-length leg CT images) were analyzed retrospectively. Resected bones of every patient were given a CT scan, and three-dimensional radiographs were reconstructed. The thickness of each bony resection was measured with the three-dimensional radiographs and recorded. The saw blade thickness (1.27 mm) was added to the measurements, and the results represented intraoperative bone resection thickness. A comparison between intraoperative bone resection thickness and preoperatively planned thickness was conducted. The differences were calculated, and the outliers were defined as >3 mm. Results. The distal femoral condyle had the most accurate bone cuts with the smallest difference (median, 1.0 mm at the distal medial femoral condyle and 0.8 mm at the distal lateral femoral condyle) and the least outliers (none at the distal medial femoral condyle and 1 (2.4%) at the distal lateral femoral condyle). The tibial plateau came in second (median difference, 0.8 mm at the medial tibial plateau and 1.4 mm at the lateral tibial plateau; outliers, none at the medial tibial plateau and 1 (2.6%) at the lateral tibial plateau). Regardless of whether the threshold was set to >2 mm (14 (17.9%) at the tibial plateau vs. 12 (14.6%) at the distal femoral condyle, p > 0.05 ) or >3 mm (1 (1.3%) at the tibial plateau vs. 1 (1.2%) at the distal femoral condyle, p > 0.05 ), the accuracy of tibial plateau osteotomy was similar to that of the distal femoral condyle. Osteotomy accuracy at the posterior femoral condyle and the anterior femoral condyle were the worst. Outliers were up to 6 (15.0%) at the posterior medial femoral condyle, 5 (12.2%) at the posterior lateral femoral condyle, and 6 (15.8%) at the anterior femoral condyle. The percentages of overcut and undercut tended to 50% in most parts except the lateral tibial plateau. At the lateral tibial plateau, the undercut percentage was twice that of the overcut. Conclusion. The tibial plateau and the distal femoral condyle share a similar accuracy of osteotomy with PSI. PSI have a generally good accuracy during the femur and tibia bone resection in TKA. PSI could be a kind of user-friendly tool which can simplify TKA with good accuracy. Level of Evidence. This is a Level IV case series with no comparison group.

scholarly journals Atraumatic Fracture of the Medial Femoral Condyle of a Total Knee Arthroplasty

2021 ◽  
Vol 8 ◽  
pp. 222-225
Author(s):  
Ricardo Ocampo ◽  
Eric Azua ◽  
Matthew Presti ◽  
Lynn Voss
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Total Knee

scholarly journals Anterior referencing versus posterior referencing in total knee arthroplasty: a prospective observational study

2016 ◽  
Vol 3 (1) ◽  
pp. 66 ◽  
Author(s):  
Preetesh Choudhary ◽  
Skand Bahre ◽  
Vinay Tantuway ◽  
Ashok Nagla ◽  
Avinash Jain ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Prospective Observational Study ◽  
Femoral Condyle ◽  
Posterior Instrumentation ◽  
Medial Femoral Condyle ◽  
Femoral Rotation ◽  
Inclusion Criteria ◽  
Component Rotation ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> Femoral component rotation in total knee arthroplasty (TKA) is essential for patella-femoral tracking, flexion gap balance and normal kinematic function of the knee. The two referencing techniques used for sizing and adjudging the femoral rotation are anterior referencing (AR) and posterior referencing (PR).The current study was designed so as to identify which referencing system determines the femoral rotation more accurately<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This study involved 34 consecutive patients (22 females and 12 males) with 60 osteoarthritic knees (bilateral=26; unilateral =8) who satisfied the inclusion criteria. The trans-epicondylar axis, was taken as gold standard to adjudge the correct femoral rotation and was marked as E. The axis of rotation as per anterior instrumentation (A), and as per posterior instrumentation (P) were marked and compared as to which of the axis (A or P) was parallel to E.<strong></strong></p><p class="abstract"><strong>Results:</strong> A was always parallel to E, however P was parallel to E in 42 knees. In 18 knees (6 with valgoid deformity, 12 with hypertrophic osteoarthritis involving the medial femoral condyle), P and E tend to converge laterally, suggestive of excessive internal rotation<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Anterior referencing determines femoral rotation more accurately than posterior referencing for knees with severe valgoid deformity or those with hypertrophic osteoarthritis involving the overgrowth of medial femoral condyle<span lang="EN-IN">.</span></p>

Circulating surgery-induced gene signatures are associated with recovery from total knee arthroplasty for knee osteoarthritis

2021 ◽  
Vol 29 ◽  
pp. S355-S356
Author(s):  
M.A. Kirksey ◽  
S.G. Lessard ◽  
M. Khan ◽  
G.A. Birch ◽  
D. Oliver ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Gene Signatures ◽  
Total Knee

scholarly journals Age and Sex Differences in Knee Osteoarthritis Patients’ Expectations of Total Knee Arthroplasty

2017 ◽  
Vol 25 ◽  
pp. S346 ◽  
Author(s):  
G.A. Hawker ◽  
D. Marshall ◽  
A. Jones ◽  
L. Woodhouse ◽  
B. Ravi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Sex Differences ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Total Knee ◽  
Age And Sex

scholarly journals MAFbx, MuRF1, and the stress-activated protein kinases are upregulated in muscle cells during total knee arthroplasty

2012 ◽  
Vol 303 (4) ◽  
pp. R376-R386 ◽  
Author(s):  
Ashley N. Bailey ◽  
Austin D. Hocker ◽  
Benjamin R. Vermillion ◽  
Keith Smolkowski ◽  
Steven N. Shah ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Muscle Protein ◽  
Vastus Lateralis ◽  
Cost Effective ◽  
Mrna Levels ◽  
Tourniquet Time ◽  
Total Knee ◽  
Expanding Population

Total knee arthroplasty (TKA) is the most common and a cost-effective surgical remediation for older adults with long-standing osteoarthritis. In parallel with the expanding population of older adults, the number of TKAs performed annually is projected to be 3.48 million by 2030. During this surgery, a tourniquet is used to stop blood flow to the operative leg. However, the molecular pathways that are affected by tourniquet use during TKA continue to be elucidated. We hypothesized that components of the catabolic FoxO3a (i.e., MuRF1, MAFbx, and Bnip3) pathway, as well as the cellular stress pathways [i.e., stress-activated protein kinase (SAPK)/JNK and MAPKs], are upregulated during TKA. The purpose of this study was to measure changes in transcripts and proteins involved in muscle cell catabolic and stress-activated pathways. We obtained muscle biopsies from subjects, 70 ± 1.3 yr, during TKA, from the vastus lateralis at baseline (before tourniquet inflation), during maximal ischemia (just before tourniquet release), and during reperfusion. Total tourniquet time was 43 ± 2 min and reperfusion time was 16 ± 1. Significant increases in FoxO3a downstream targets, MAFbx and MuRF1, were present for mRNA levels during ischemia (MAFbx, P = 0.04; MuRF1, P = 0.04), and protein expression during ischemia (MAFbx, P = 0.002; MuRF1, P = 0.001) and reperfusion (MuRF1, P = 0.002). Additionally, stress-activated JNK gene expression ( P = 0.01) and protein were elevated during ischemia ( P = 0.001). The results of this study support our hypothesis that protein degradation pathways are stimulated during TKA. Muscle protein catabolism is likely to play a role in the rapid loss of muscle volume measured within 2 wk of this surgery.

Sign in / Sign up

Export Citation Format

Share Document