scholarly journals Total knee replacement modifies the preoperative tibial torsion angle—similar results between computer-assisted and standard technique

2018 ◽  
Vol 6 (7) ◽  
pp. 113-113
Author(s):  
Daniel Hernandez-Vaquero ◽  
Alfonso Noriega-Fernandez ◽  
Sergio Roncero-Gonzalez ◽  
Andres A. Sierra-Pereira ◽  
Manuel A. Sandoval-Garcia
Author(s):  
Mohsen Safaei ◽  
Steven R. Anton

Total knee replacement has been utilized to restore the functionality of diseased knee joints for more than four decades. Today, despite the relatively high level of patient satisfaction, still about 20% of patients are not fulfilled with their surgical outcomes in terms of function and reduction in pain. There is still an ongoing discussion on correlating the postoperative functionality of the joint to intraoperative alignment, which suffers from lack of in vivo data from the knee after surgery. However, it is necessary to mention that using computer assisted surgical techniques, the outcomes of knee replacement procedures have been remarkably improved. In order to obtain information about the knee function after the operation, the design of a self-powered instrumented knee implant is proposed in this study. The design is a total knee replacement ultra high molecular weight polyethylene insert equipped with four piezoelectric transducers distributed in the medial and lateral compartments of the bearing. The piezoelectric elements are employed to measure the axial force applied on the tibial insert through the femoral component of the joint as well as to track the movement in the center of pressure. In addition, generated voltage from the piezoelectrics is harvested and stored to power embedded electronics for further signal conditioning and data transmitting purposes. The performance of the instrumented implant is investigated via experimental testing on a fabricated prototype in terms of sensing and power harvesting capacity. Piezoelectric force and center of pressure measurements are compared to the actual quantities recorded from the load frame and pressure sensitive films in order to evaluate the performance of the sensing system. The output voltage of the piezoelectric transducers is rectified and stored in a capacitor to evaluate the energy harvesting ability of the system. The results show only a small level of error in sensing the force and the location of center of pressure. Additionally, a 4.9 V constant voltage is stored in a 3.3 mF capacitor after 3333 loading cycles. The sensing and energy harvesting results present the promising potential of this system to be used as an integrated self-powered instrumented knee implant.


2010 ◽  
Vol 35 (3) ◽  
pp. 331-339 ◽  
Author(s):  
Yaron S. Brin ◽  
Vassilios S. Nikolaou ◽  
Lawrence Joseph ◽  
David J. Zukor ◽  
John Antoniou

10.29007/65qr ◽  
2020 ◽  
Author(s):  
Kamal Deep ◽  
Frederic Picard

The accuracy of implantation using computer navigation and robotic total knee replacement (TKR) has been proven. Time taken during surgery has been a factor for surgeons for not using the technology. Aim of this study was to analyse time taken in different steps and identify which part needs improvement. Robotic time was compared to computer navigation. Methods: 15TKR were performed with MAKO robot. Software for the ligament balancing was used. All had CT scan preoperatively. Time of different surgical steps was recorded. Time for computer navigation was recorded too. After joint exposure, trackers and verification pins for tibia and femur were inserted. Femoral registration matching started at 10.8 minutes (SD3.3 Range7-20). It took 3.2 minutes to match femoral anatomy to CT scan. Tibial registration done at 14.1minutes (SD3 Range10- 23). Once matching was accepted to required accuracy, tibial cut was made at 22.2 minutes (SD4.4 Range 15-30). Next the soft tissues were assessed with tensioner. It took 6.3 minutes (SD 5.6). Final femoral preparation done at 35.7 minutes (SD 5.6 Range25-45). Trial performed at 52 minutes (SD7.3 Range42-63). Implants were cemented at 63.4 minutes (SD8 Range50-72). Wound closed at 77.6 minutes (SD9.5 Range65-97). The computer navigated TKR surgery took 70 minutes on an average. Compared to navigation, robotic technique took approximately 7 minutes longer, not significantly different. This could be due to learning curve of the surgical and theatre team. Improvement is required in different steps. The familiarity of staff will increase the efficiency. Registration matching took 11.4 minutes. Femoral preparation took 17 minutes. These steps could be streamlined.


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