scholarly journals Potential Instability and Malfunction of Knee Joints with Vastus Medialis Impairment after Total Knee Arthroplasty

2021 ◽  
Vol 11 (6) ◽  
pp. 2764
Author(s):  
Yongkyung Lee ◽  
Hai-Mi Yang ◽  
Jinju Jang ◽  
Dai-Soon Kwak ◽  
Jungsung Kim ◽  
...  

Four pairs of fresh-frozen cadaver knees (eight knees, four male knees) with a mean age of 72 ± 7 years were used for tests involving a customized simulator capable of controlling quadriceps loading conditions. The muscle force distribution of the quadriceps for the normal loading condition was applied on the basis of muscle cross-sectional area data, as previously reported (VM: 31 N; RF/VI: 49 N; VL: 45 N). To simulate vastus medialis (VM) impairment, we set the muscle force for VM in the muscle force distribution of the quadriceps at zero (VM: 0 N; RF/VI: 49 N; VL: 45 N). The joint reaction forces and moments on knee joints that underwent total knee arthroplasty (TKA) did not differ significantly according to VM impairment status for all flexion angles (p > 0.05). Nevertheless, the vectors of internal–external moments mostly showed a tendency for alteration from external to internal due to VM impairment. This tendency was evident in 9 cases in 12 total test pairs (with and without VM impairment). Furthermore, the vectors of the anterior–posterior reaction forces mostly showed a tendency to increase anteriorly due to VM impairment. This tendency was also evident in 9 cases in 12 total test pairs (with and without VM impairment). These results indicate that posterior dislocation of the tibia may be induced if VM impairment occurs after TKA. In conclusion, VM impairment in knee joints undergoing TKA may contribute to posterior dislocation of the tibia by a paradoxical roll-back with enhancements of the anterior joint reaction force and external moment during knee-joint flexion. Our findings may be valuable for understanding the mechanism of potential instability and malfunction due to VM impairment in knee joints after TKA, and may help to optimize clinical/rehabilitation training plans to improve the prognosis (stability and function) of knee joints undergoing TKA.

2017 ◽  
Vol 31 (05) ◽  
pp. 422-424
Author(s):  
James Kohlman ◽  
Craig Valle ◽  
Muthana Sartawi

AbstractThe modified intervastus approach to the anterior knee is an approach that may be used in the majority of patients undergoing total knee arthroplasty. This article presents the first description of this approach. The advantages of this approach include its extensile nature, similar to a medial parapatellar approach, and preservation of the extensor mechanism and the vastus medialis, leading to a more rapid return to active knee extension than is traditionally observed. The approach is also simple to perform, easy to close, and is compatible with more extensile approaches such as a quadriceps snip if required in revision scenarios.


2014 ◽  
Vol 29 (6) ◽  
pp. 1143-1148 ◽  
Author(s):  
Jessica W. Smith ◽  
Robin L. Marcus ◽  
Christopher L. Peters ◽  
Christopher E. Pelt ◽  
Brian L. Tracy ◽  
...  

Author(s):  
Mohd Hanafi Mat Som ◽  
◽  
Kouki Nagamune ◽  
Takashi Kamiya ◽  
Shogo Kawaguchi ◽  
...  

Soft tissue or ligament balancing in total knee arthroplasty is important for ensuring knee joint stability. Correct balancing and appropriate alignment of ligaments extend prosthesis life by preventing unnecessary force fromacting on the prosthesis during routine activities. The current implementation of total knee arthroplasty relies heavily on the subjective “feel” of the surgeon for correct prosthesis implantation onto tibiofemoral components. We developed a force distribution sensing systemto provide quantitative information to surgeons during ligament balancing. The measurement system consists of two main components: two force sensors embedded in trial insert for each condyle and signal acquisition for data processing and force visualization. Sensors were designed and developed using pressure-sensitive conductive rubber that measures changes in resistance in the event of deformation caused by external force. Corresponding voltage measured by circuits is transmitted via an RF transceiver to a computer and visualized as color gradient. Current sensors could measure maximum force of 196.13 N (20 kgf). Results from calibration and experiments on a plastic trial prosthesis indicated that the device has good potential for providing appropriate force distribution information on the knee during total knee arthroplasty procedure.


2010 ◽  
Vol 59 (2) ◽  
pp. 310-313
Author(s):  
Tomoyuki Oshiro ◽  
Takeyuki Miyazato ◽  
Shinichi Shirota ◽  
Muneyuki Hayashi ◽  
Yoshitake Oshiro ◽  
...  

2016 ◽  
Vol 34 (9) ◽  
pp. 1576-1587 ◽  
Author(s):  
Alessandro Navacchia ◽  
Paul J. Rullkoetter ◽  
Pascal Schütz ◽  
Renate B. List ◽  
Clare K. Fitzpatrick ◽  
...  

The Knee ◽  
1998 ◽  
Vol 5 (3) ◽  
pp. 183-186 ◽  
Author(s):  
James M Schneider ◽  
James V Bono ◽  
Franklin Glockner ◽  
Joel Melnikoff ◽  
Frederick Fletcher

The Knee ◽  
2017 ◽  
Vol 24 (2) ◽  
pp. 409-418 ◽  
Author(s):  
Jiang-ming Luo ◽  
Lin Guo ◽  
Hao Chen ◽  
Peng-fei Yang ◽  
Ran Xiong ◽  
...  

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