scholarly journals How to choose kinematic or mechanical alignment individually according to preoperative characteristics of patients?

2020 ◽  
Author(s):  
Chong Luan ◽  
Dong-Tan Xu ◽  
Ning-Jie Chen ◽  
Fei-Fei Wang ◽  
Kang- Song Tian ◽  
...  

Abstract Background Making decision in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA).Methods We reviewed 296 patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a portable navigation system from 2016 to 2018 in our prospectively maintained database. The minimum followup was 1 year. Clinical outcomes including range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS. Results ROM and KSS at the 1-year followup didn’t differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05), Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05). Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.

2020 ◽  
Author(s):  
Chong Luan ◽  
Dong-Tan Xu ◽  
Ning-Jie Chen ◽  
Fei-Fei Wang ◽  
Kang- Song Tian ◽  
...  

Abstract Background Making decision in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA). Methods We reviewed 296 patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a portable navigation system from 2016 to 2018 in our prospectively maintained database. The minimum followup was 1 year. Clinical outcomes including range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS. Results ROM and KSS at the 1-year followup didn’t differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05), Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05). Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.


2020 ◽  
Author(s):  
Chong Luan ◽  
Dong-Tan Xu ◽  
Ning-Jie Chen ◽  
Fei-Fei Wang ◽  
Kang- Song Tian ◽  
...  

Abstract Background Making decisions in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA). Methods We reviewed 296 consecutive patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a computer-assisted navigation from 2016 to 2018 in our prospectively maintained database. The minimum followup was one year. Clinical outcomes including the range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS.Results ROM and KSS at the 1-year followup didn't differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with a BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05). Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05).Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.


2020 ◽  
Author(s):  
Chong Luan ◽  
Dong-Tan Xu ◽  
Ning-Jie Chen ◽  
Fei-Fei Wang ◽  
Kang- Song Tian ◽  
...  

Abstract Background Making decisions in alignment techniques in total knee arthroplasty (TKA) remains controversial. This study aims to identify the potential patients who were suitable for the kinematic (KA) or mechanical alignment (MA). Methods We reviewed 296 consecutive patients (296 TKAs, including 114 KA-TKAs and 182 MA-TKAs) who underwent unilateral TKA using a computer-assisted navigation from 2016 to 2018 in our prospectively maintained database. The minimum followup was one year. Clinical outcomes including the range of motion (ROM) and knee society score (KSS) were compared between KA-TKAs and MA-TKAs. Multiple regression models were used to evaluate the relationship between alignment techniques and KSS at the 1-year followup. Interaction and stratified analyses were conducted according to gender, age, body mass index (BMI), preoperative hip-knee-ankle (HKA) angle, ROM and KSS.Results ROM and KSS at the 1-year followup didn't differ between MA-TKAs and KA-TKAs (all p>0.05). Alignment techniques did not associate with postoperative ROM (Adjusted β=0.4, 95% confidence interval [CI]: -0.3, 1.6; p=0.752) or 1-year KSS (Adjusted β=2.2, 95%CI: -0.7, 5.6; p=0.107). Patients with a BMI more than 30 kg/m^2 achieved better 1-year KSS when using MA than KA (p for interaction<0.05). Additionally, patients with preoperative HKA angle more than 10 degrees varus benefited more from KA than MA (p for interaction<0.05).Conclusions Patients with severe varus deformity may be suitable for the KA technique, whereas MA should be used in obese patients.


Author(s):  
Ayooluwa Femi Aribisala ◽  
Musa Mohammed

Energy consumers in Nigeria have long complained about Distribution Companies' unfair billing practices, exorbitant monthly electricity bills resulting from meter estimation rather than accurate meter reading and calculation based on uninterrupted electricity use. The objectives of the study were to establish the relationship between the prepaid metering system and customer satisfaction; and to evaluate the level of satisfaction with respect to the usage of the prepaid metering system in Niger State, Nigeria. In carrying out the study, the structured questionnaire was administered to 393 randomly chosen respondents drawn from prepaid meter users, out of which 344 responded generating a response rate of 87.5%. The data derived were subjected to spearman correlation and multiple regression models. The major findings from the study showed a significant, moderate and positive relationship between the prepaid metering system and customer satisfaction. Additionally, three significant predictors, Affordability, Availability and Flexibility with p < .01 are statistically significant. Further findings from descriptive statistics revealed that users had the highest level of satisfaction with the privacy they had as a result of no meter readers and no accumulated. The study concluded that there exist a positive and beneficial link between the prepaid metering system and customer satisfaction. The study therefore recommends the provision of a smart metering system, good customer care units and a marketing campaign for better knowledge of the prepaid metering system.


2011 ◽  
Vol 4 ◽  
pp. ASWR.S6918 ◽  
Author(s):  
Dan Lindgren ◽  
Magnus Karlsson

Coastal sediment can be classified by functional bottom type, depending on whether cohesive fine material is eroded (E), transported (T) or deposited/accumulated (A) there. The assessment of such bottom dynamic conditions is useful in many ways, including as a fundament for structuring mass balance models. In this paper more than 200 recently investigated Swedish coastal areas were analyzed using geographic information systems (GIS). Statistical relationships between morphometry, the average proportion of A-areas (BA) and the average critical depth (DTA), which separates ET-areas from A-areas, were investigated. Many morphometric parameters showed significant correlation with both BA and DTA and multiple regression models were obtained that could explain much of the variation in these parameters. Parameters describing sheltering effects from islands, mean depth and mean slope were important in this context. Large differences were found in empirical BA-values from two different sources. Furthermore, a new empirical dataset was presented for 209 Swedish coastal areas.


2018 ◽  
Vol 3 (3) ◽  
pp. 63-71
Author(s):  
Prem Bahadur Budhathoki ◽  
Chandra Kumar Rai

The aim of the study is to explore the relationship between a net profit of Nepalese commercial banks with staff expenses and staff bonus. This study is based on panel data which is collected from five sampled banks through the review of the annual report during the study period of fiscal year 2012/13 to 2016/17. These collected data are analyzed by using descriptive statistics, Pearson correlation coefficient, and log-log multiple regression models. The Mini-Tab software is used for the analysis of data. The results indicate that the predictor variable staff expenses do not significantly impact on net profits of the bank even though they are positively correlated. On the other hand, the response variable (net profit) is significantly affected by the predictor variable staff bonus. Researcher: A Research Journal of Culture and SocietyVol. 3, No. 3, January 2018, Page: 63-71 


2014 ◽  
Vol 3 (2) ◽  
Author(s):  
Herni Ali

The aim of this study is examining the relationship between cointergration and causality levels of Exchange Rate, GDP, BI interest rates and inflation on Islamic Capital Markets. The data used in this study is a quantitative secondary data in the form of time series of the period January 2010 to December 2013. The test were conducted with the approach of multiple regression models with variable index research JII (Y), the exchange rate (X1), GDP (X2) , BI rate (X3) and inflation (X4) as for hypothesis testing performed using SPSS statistical software. From the results obtained by testing the hypothesis that: a positive effect on the exchange rate, positive effect on GDP, interest harga sewa rates BI negative effect and inflation positive effect on JII. Simultanious testing into four macroeconomic variables affect the JII.DOI: 10.15408/sjie.v3i2.2061   


2021 ◽  
Vol 103-B (6 Supple A) ◽  
pp. 59-66
Author(s):  
Sarag Abhari ◽  
Thomas M. Hsing ◽  
Max M. Malkani ◽  
Austin F. Smith ◽  
Langan S. Smith ◽  
...  

Aims Alternative alignment concepts, including kinematic and restricted kinematic, have been introduced to help improve clinical outcomes following total knee arthroplasty (TKA). The purpose of this study was to evaluate the clinical results, along with patient satisfaction, following TKA using the concept of restricted kinematic alignment. Methods A total of 121 consecutive TKAs performed between 11 February 2018 to 11 June 2019 with preoperative varus deformity were reviewed at minimum one-year follow-up. Three knees were excluded due to severe preoperative varus deformity greater than 15°, and a further three due to requiring revision surgery, leaving 109 patients and 115 knees to undergo primary TKA using the concept of restricted kinematic alignment with advanced technology. Patients were stratified into three groups based on the preoperative limb varus deformity: Group A with 1° to 5° varus (43 knees); Group B between 6° and 10° varus (56 knees); and Group C with varus greater than 10° (16 knees). This study group was compared with a matched cohort of 115 TKAs and 115 patients using a neutral mechanical alignment target with manual instruments performed from 24 October 2016 to 14 January 2019. Results Mean overall patient satisfaction for the entire cohort was 4.7 (SE 0.1) on a 5-point Likert scale, with 93% being either very satisfied or satisfied compared with a Likert of 4.3 and patient satisfaction of 81% in the mechanical alignment group (p < 0.001 and p < 0.006 respectively). At mean follow-up of 17 months (11 to 27), the mean overall Likert, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, Western Ontario and McMaster Universities Osteoarthritis Index, Forgotten Joint Score, and Knee Society Knee and Function Scores were significantly better in the kinematic group than in the neutral mechanical alignment group. The most common complication in both groups was contracture requiring manipulation under anaesthesia, involving seven knees (6.1%) in the kinematic group and nine knees (7.8%) in the mechanical alignment group. Conclusion With the advent of advanced technology, and the ability to obtain accurate bone cuts, the target limb alignment, and soft-tissue balance within millimetres, using a restricted kinematic alignment concept demonstrated excellent patient satisfaction following primary TKA. Longer-term analysis is required as to the durability of this method. Cite this article: Bone Joint J 2021;103-B(6 Supple A):59–66.


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