scholarly journals Kinematic Alignment Technique for TKA on Degenerative Knees with Severe Bone Loss: A Report of 3 Cases

2021 ◽  
Vol 15 (1) ◽  
pp. 27-34
Author(s):  
Charles Rivière ◽  
Jeremy Webb ◽  
Pascal-André Vendittoli
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Joint ◽  
Kinematic Alignment ◽  
Significant Challenge ◽  
Severe Bone Loss ◽  
Alignment Technique ◽  
Total Knee ◽  
Key Steps ◽  
Arthritic Knee

A severely degenerative knee joint with substantial bone attrition poses a significant challenge when performing Total Knee Arthroplasty (TKA) using the Kinematic Alignment (KA) technique. In order to restore the pre-arthritic knee anatomy, the surgeon has the task of estimating quantity and location of bone loss. We present three such cases and describe the key steps to safely perform KATKA in these complex situations.

scholarly journals Anatomic Versus Mechanically Aligned Total Knee Arthroplasty for Unicompartmental Knee Arthroplasty Revision

2016 ◽  
Vol 10 (1) ◽  
pp. 357-363 ◽  
Author(s):  
Panagiota Toliopoulos ◽  
Marc-Andre LeBlanc ◽  
Jonathan Hutt ◽  
Martin Lavigne ◽  
Francois Desmeules ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Womac Score ◽  
Kinematic Alignment ◽  
Mechanical Alignment ◽  
Medial Proximal Tibial Angle ◽  
Alignment Technique ◽  
Total Knee ◽  
Small Patient

Objectives:The purpose of this study was to compare the intra-operative benefits and the clinical outcomes from kinematic or mechanical alignment for total knee arthroplasty (TKA) in patients undergoing revision of failed unicompartmental kneel arthroplasty (UKA) to TKA.Methods:Ten revisions were performed with a kinematic alignment technique and 11 with a mechanical alignment. Measurements of the hip-knee-ankle angle (HKA), the lateral distal femoral angle (LDFA), and the medial proximal tibial angle (MPTA) were performed using long-leg radiographs. The need for augments, stems, and constrained inserts was compared between groups. Clinical outcomes were compared using the WOMAC score along with maximum distance walked as well as knee range of motion obtained prior to discharge. All data was obtained by a retrospective review of patient files.Results:The kinematic group required less augments, stems, and constrained inserts than the mechanical group and thinner polyethylene bearings. There were significant differences in the lateral distal femoral angle (LDFA) and the medial proximal tibial angle (MPTA) between the two groups (p<0.05). The mean WOMAC score obtained at discharge was better in the kinematic group as was mean knee flexion. At last follow up of 34 months for the kinematic group and 58 months for the mechanical group, no orthopedic complications or reoperations were recorded.Conclusion:Although this study has a small patient cohort, our results suggest that kinematic alignment for TKA after UKA revision is an attractive method. Further studies are warranted.

Management of Chronically Infected Total Knee Arthroplasty With Severe Bone Loss Using Static Spacers With Intramedullary Rods

2019 ◽  
Vol 34 (7) ◽  
pp. 1462-1469 ◽  
Author(s):  
Christian Hipfl ◽  
Tobias Winkler ◽  
Viktor Janz ◽  
Carsten Perka ◽  
Michael Müller
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Arthroplasty ◽  
Infected Total Knee Arthroplasty ◽  
Severe Bone Loss ◽  
Total Knee

Excellent two-year survivorship of 3D-printed metaphyseal cones in revision total knee arthroplasty

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 107-115 ◽  
Author(s):  
Matthew W. Tetreault ◽  
Kevin I. Perry ◽  
Mark W. Pagnano ◽  
Arlen D. Hanssen ◽  
Matthew P. Abdel
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Severe Bone Loss ◽  
Implant Survivorship ◽  
History Of ◽  
3D Printed ◽  
Total Knee ◽  
The Mean

Aims Metaphyseal fixation during revision total knee arthroplasty (TKA) is important, but potentially difficult when using historical designs of cone. Material and manufacturing innovations have improved the size and shape of the cones which are available, and simplified the required bone preparation. In a large series, we assessed the implant survivorship, radiological results, and clinical outcomes of new porous 3D-printed titanium metaphyseal cones featuring a reamer-based system. Methods We reviewed 142 revision TKAs in 139 patients using 202 cones (134 tibial, 68 femoral) which were undertaken between 2015 and 2016. A total of 60 involved tibial and femoral cones. Most cones (149 of 202; 74%) were used for Type 2B or 3 bone loss. The mean age of the patients was 66 years (44 to 88), and 76 (55 %) were female. The mean body mass index (BMI) was 34 kg/m2 (18 to 60). The patients had a mean of 2.4 (1 to 8) previous operations on the knee, and 68 (48%) had a history of prosthetic infection. The mean follow-up was 2.4 years (2 to 3.6). Results Survivorship free of cone revision for aseptic loosening was 100% and survivorship free of any cone revision was 98%. Survivorships free of any revision and any reoperation were 90% and 83%, respectively. Five cones were revised: three for infection, one for periprosthetic fracture, and one for aseptic tibial loosening. Radiologically, three unrevised femoral cones appeared loose in the presence of hinged implants, while the remaining cones appeared stable. All cases of cone loosening occurred in patients with Type 2B or 3 defects. The mean Knee Society score (KSS) improved significantly from 50 (0 to 94) preoperatively to 87 (72 to 94) (p < 0.001). Three intraoperative fractures with cone impaction (two femoral, one tibial) healed uneventfully. Conclusion Novel 3D-printed titanium cones, with a reamer-based system, yielded excellent early survivorship and few complications in patients with severe bone loss undergoing difficult revision TKA. The diversity of cone options, relative ease of preparation, and outcomes rivalling those of previous designs of cone support their continued use. Cite this article: Bone Joint J 2020;102-B(6 Supple A):107–115.

Revision total knee arthroplasty: experience with tantalum cones in severe bone loss

2013 ◽  
Vol 4 (3) ◽  
pp. 131-136 ◽  
Author(s):  
Matteo Fosco ◽  
Luca Amendola ◽  
Rossana Fantasia ◽  
Gennaro Pipino ◽  
Domenico Tigani
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Loss ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Severe Bone Loss ◽  
Total Knee
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