scholarly journals Factors Affecting Squatting Ability in Total Knee Arthroplasty Using High Flexion Prosthesis

2021 ◽  
Author(s):  
Tiejian Li ◽  
Jingyang Sun ◽  
Yinqiao Du ◽  
Zhisen Gao ◽  
Haiyang Ma ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Influencing Factors ◽  
Knee Arthroplasty ◽  
Univariate Analysis ◽  
Joint Line ◽  
Line Position ◽  
P Values ◽  
Factors Affecting ◽  
Group I ◽  
Total Knee

Abstract Background: Total knee arthroplasty (TKA) is widely used as a treatment for knee osteoarthritis. Few studies have analyzed the factors affecting squatting ability of patients after TKA. The purpose of this study is to comprehensively analyze the factors affecting squatting ability after TKA and to determine which important factors should be paid attention to.Methods: Three hundred primary TKA cases with a minimum 3-year follow-up were retrospectively analyzed. All patients received a conventional posterior-stabilized TKA implant and underwent a standard perioperative care pathway. The patients were divided into two groups according to the knee flexion angle (Group I -squatting group, Group II - inability squatting group). Demographic, operative, and clinical data were collected. Radiographic assessment included joint line joint line elevation, patella position, posterior condylar offset (PCO) , etc. Statistical analysis of effect of all the above factors on squatting ability was done. Results: The univariate analysis showed age, prosthesis size, preoperative ROM and joint line position were correlated with squatting ability (p-values ≤0.10). In the final multivariate analysis, joint line position and preoperative ROM were independent influencing factors that affecting squatting ability after TKA (p-values < 0.01). Conclusion: Preoperative ROM and joint line position were independent influencing factors affecting squatting ability after TKA. Patients should be counseled accordingly and made to understand these factors. In order to ensure patients can squat postoperatively, we should improve surgical techniques to control joint line elevation.

scholarly journals Changes of ankle inclinations after total knee arthroplasty

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0010
Author(s):  
Murat Celal Sözbilen ◽  
Elcil Kaya Biçer ◽  
Semih Aydoğdu ◽  
Hakkı Sur
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Ankle Joint ◽  
Knee Arthroplasty ◽  
Joint Line ◽  
X Rays ◽  
Group I ◽  
Total Knee ◽  
Group Ii ◽  
Line Inclination

Aim: To evaluate the changes in ankle joint line inclination in patients who had total knee arthroplasty due to degenerative osteoarthritis. Material/Method: Sixty-two knees (with a mean age of 71,66±6,78 years, follow-up 52,34±27,42 months) which had undergone total knee arthroplasty between November 1996 and May 2014 were included in this retrospective study. The knee joint line orientations (KJLO) of the prosthesis and ankle joint line inclination (AJLI) relative to the floor were evaluated on postoperative standard standing long-leg X-rays. The AJLI relative to the floor was defined as the angle between the tangent to the subchondral plate of the talus and the horizontal grid line on radiographs. In order to determine the effects of KJLO and high varus on AJLI, patients were divided into two each groups that were pre-operative mechanical axes (MA) as <20° (n=35, group1) and >=20° (n=27, group2) and post-operative MA <3° (n=32, group a) and >=3° (n=30, group b). In addition, the changes in AJLI were compared between each group. The patients were regrouped as either <=3° (n=28, group i) or >3° (n=34, group ii), in terms of the postoperative KJLO. Inclination angles of the prosthesis were compared between each groups. Statistical analysis was performed with SPSS v18. Results: Mean MA of pre-operative and post-operative were 16,35±6,56° and 3,92±3,35°, respectively. All ankle inclinations were lateralized. AJLI, were significantly decreased from pre-operative mean 7,37°±3,19° to post-operative mean 3,71°±2,22° (p<0,0001). The mean of change was 3,65°±3,03°. However, pre-operative AJLIs were significantly increased in high varus group (group1: 6,34°±2,54°, group2: 8,70°±3,48°, p=0,003); post-operative AJLIs did not differ significantly (group1: 3,55°±2,36°, group2: 3,92°±2,05°, p=0,516) with respect to the MA. The changes in preop-postop AJLI’s were significantly higher in high varus group again (p=0,009). When the KJLO groups were compared, pre-operative AJLIs were significantly different (group i: 6,25°±2,33°, group ii: 8,29°±3,53°, p=0,004) while post-operative AJLIs did not differ significantly (group i: 3,46°±2,38°, group ii: 3,92°±2,08°, p=0,489). Conclusion: Pre-operatively high varus knees also had high ankle varus, hence ankle deformity was corrected by the restoration of the optimal lower limb aligment. Obtaining parallel orientation of the components relative to the ground, restored the AJLI. Pre-operative planning and convenient implantation of the components lead to achieve optimum knee orientation which restored the ankle joint line orientation independent from mechanical axes. Not only the goal of optimum mechanical axes but also optimum knee joint line orientation’s importance was demonsrated.

Joint line position in revision total knee arthroplasty: the role of posterior femoral off-set stems

The Knee ◽  
2013 ◽  
Vol 20 (6) ◽  
pp. 447-450 ◽  
Author(s):  
Massimo Innocenti ◽  
Fabrizio Matassi ◽  
Christian Carulli ◽  
Stefano Soderi ◽  
Marco Villano ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Joint Line ◽  
Line Position ◽  
Total Knee

scholarly journals A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

2020 ◽  
Author(s):  
Hua Han ◽  
Xiaohui Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Measurement Method ◽  
Intraclass Correlation ◽  
Patellar Height ◽  
Joint Line ◽  
New Method ◽  
Line Position ◽  
Before And After ◽  
Total Knee

Abstract Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analyses were respectively used to evaluate the reliabilities and correlations.Results: There were good correlations between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92).Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

scholarly journals A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hua Han ◽  
Xiaohui Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Measurement Method ◽  
Intraclass Correlation ◽  
Patellar Height ◽  
Joint Line ◽  
New Method ◽  
Line Position ◽  
Before And After ◽  
Total Knee

Abstract Background The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively. Methods Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analyses were respectively used to evaluate the reliabilities and correlations. Results There were good correlations between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92). Conclusions The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

scholarly journals A new method for evaluation of patellar height and the position of the joint line before and after total knee arthroplasty

2020 ◽  
Author(s):  
Hua Han ◽  
Xiaohui Zhang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Measurement Method ◽  
Intraclass Correlation ◽  
Patellar Height ◽  
Joint Line ◽  
New Method ◽  
Line Position ◽  
Before And After ◽  
Total Knee

Abstract Background: The measurement of patellar height and restoration of the natural position of the joint line are crucial to total knee arthroplasty (TKA). However, there remains a lack of consensus on an optimal measurement method to associate the patellar height with the joint line position. The objective of this study was to introduce a new method and validate the application in TKA both preoperatively and postoperatively.Methods: Instead of taking marginal landmarks as the tibial references, the tibial shaft axis was used to construct the new measurement method, which comprises the axis-patella (AP), joint axis-patella (jAP) indices and joint line height (JLH). Patellar heights were measured using the Insall-Salvati (IS), modified Insall-Salvati (mIS), Blackburne-Peel (BP), Caton-Deschamps (CD) indices, and the new method in 175 knees both preoperatively and postoperatively. Intraclass correlation coefficients and Pearson’s correlation analysis were respectively used to evaluate the reliabilities and correlations.Results: There was good correlation between the proposed method and the mIS, CD, and BP indices. High inter-observer reproducibility was found for AP (preoperative and postoperative 0.83), jAP (preoperative 0.82; postoperative 0.86) indices and JLH (preoperative 0.88; postoperative 0.95). High intra-observer repeatability was also found for AP (preoperative 0.85; postoperative 0.87), jAP (preoperative 0.83; postoperative 0.87) indices and JLH (preoperative 0.80; postoperative 0.92). Conclusions: The new method is reliable for measuring patellar height before and after TKA, providing an alternative to distinguish between true and pseudo patella baja. Furthermore, JLH can be applied to assess and restore the joint line position in TKA.

Factors Affecting Flexion after Total Knee Arthroplasty

2007 ◽  
Vol 464 ◽  
pp. 53-60 ◽  
Author(s):  
Douglas A Dennis ◽  
Richard D Komistek ◽  
Giles R Scuderi ◽  
Sumesh Zingde
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Factors Affecting ◽  
Total Knee

scholarly journals Is adding intra-articular steroid in total knee arthroplasty cocktail obligatory?

2019 ◽  
Vol 5 (2) ◽  
pp. 260
Author(s):  
Sundar Suriyakumar ◽  
Ganesan G. Ram ◽  
Faraz Ahmed
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Knee Replacement Surgery ◽  
Replacement Surgery ◽  
Total Knee Replacement Surgery ◽  
Group I ◽  
Total Knee

<p class="abstract"><strong>Background:</strong> The patients can undergo total knee replacement surgery either under general anaesthesia, combined spinal and epidural anaesthesia, nerve root block, spinal combined with intra-articular knee cocktail. There is an ongoing debate amongst Arthroplasty surgeons whether to include steroid in the cocktail or not. The aim of this study is to assess whether there is an added benefit of including steroid in the intraarticular mixture.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted at Sri Ramachandra Institute of Higher education, Chennai between December 2017 to December 2018. The study was conducted in the Arthroplasty unit, Department of Orthopaedics. SRIHER ethics committee clearance was obtained prior to the start of the study. The inclusion criteria were patients who underwent total knee replacement surgery under combined spinal and intra-articular knee cocktail. Patients were divided into two groups based on the use of steroid in the intra-articular mixture. Patients were evaluated using Visual analogue scale, opioids usage as primary endpoint while any joint infection within six months of the surgery and knee society score at 1 month and 6 months as the secondary endpoint.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean visual analogue score for the 0 pod for the group I and group II were 2.3 and 2.4 respectively. There was no case of infection in both groups.</p><p class="abstract"><strong>Conclusions:</strong> There is no fringe benefit of adding steroid to the knee cocktail. So it is not obligatory to add steroid in intra-articular total knee arthroplasty cocktail.</p>

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