COMPARISON OF HIGH FLEXION DESIGN AND POSTERIOR STABILIZATION PROSTHESES OF TOTAL KNEE ARTHROPLASTY BY GAIT ANALYSIS

2009 ◽  
Vol 21 (01) ◽  
pp. 71-79
Author(s):  
Wen-Chi Tsai ◽  
Sheng-Chang Chen ◽  
Tung-Wu Lu ◽  
Hwa-Chang Liu
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Objective Assessment ◽  
Knee Prostheses ◽  
High Flexion ◽  
Significant Difference ◽  
Post Operation ◽  
Total Knee

Introduction: The primary goal of total knee arthroplasty (TKA) is to resolve knee destruction and associated problems at the end stages of diseases such as osteoarthritis and rheumatoid arthritis. High satisfactory rate has been reported in terms of pain relief and correction of deformity. However, the method for objective assessment of the outcome, such as range of motion (ROM) and quantitative evaluation of the clinical outcome of TKA, is to be confirmed. The purpose of this study was mandatory to investigate the ROM objectively and the newly designed prostheses. Materials and methods: The study was done in randomly selected patients who received dynamic measurement of knee function. Twenty-six patients participated in the study. They were divided into two groups (13 patients in A and 13 patients in B group), according to the knee prostheses they had received. Basic knee functions were evaluated in various dynamic activities, including nonweight bearing status of knee flexion, level walking, kneeling, and squatting, using computerized gait analysis techniques (Vicon 512 system). Passive knee ROM and static alignment were measured using traditional goniometer. HSS scores, physical, and neural examination were recorded. Results: After comparing patients in almost similar criteria, results have shown that there was no significant difference between two types of knee prostheses in randomly selective patients. Conclusion: Newly designed prostheses for achieving higher flexion angle cannot guarantee to provide better knee flexion for every patient. A patient, who can achieve higher knee flexion in pre-operative status, will have high flexion results in post-operative result. In other words, poor knee flexion function in pre-operation will lead to poor knee flexion function in post-operation status. Minor prosthesis design has little to do with the surgical outcome of knee flexion.

scholarly journals Comparison of periarticular multidrug infiltration and epidural catheter use in total knee arthroplasty: A prospective randomized controlled study

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902091066
Author(s):  
Taku Ukai ◽  
Hamahashi Kosuke ◽  
Goro Ebihara ◽  
Masahiko Watanabe
Keyword(s):  
Total Knee Arthroplasty ◽  
Epidural Catheter ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Whole Body ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Catheter Group ◽  
Significant Difference ◽  
Total Knee

Purpose: The purpose of this study was to assess the effectiveness of periarticular multidrug infiltration (PMDI) and compare it with that of epidural catheter use. Methods: Fifty-eight patients (58 joints) who underwent total knee arthroplasty were included in this single-center, prospective, parallel, randomized, controlled trial. Preoperatively, patients were randomly categorized into the PMDI and epidural catheter groups. We evaluated postoperative pain (visual analog scale (VAS) and narcotic consumption), functional outcomes (range of motion (ROM) of knee flexion, the day patients could perform the straight-leg raising (SLR) test, and day of starting cane use), and laboratory data (white blood cell (WBC) and C-reactive protein (CRP)). Results: There was no significant difference in the VAS score, ROM of knee flexion, the day patients could do SLR, and the day of starting cane use between the PMDI and epidural catheter groups. However, the PMDI group could perform SLR on a postoperative day (POD) 1 ( p < 0.05). WBC level on POD 1 was significantly higher in the PMDI group ( p < 0.05), whereas the CRP levels on POD 1 ( p < 0.01), 3 ( p < 0.01), and 5 ( p < 0.01) were significantly lower in the PMDI group than in the epidural catheter group. The frequency of side effects was not significantly different between the groups. Conclusion: PMDI was as effective as epidural catheter use for pain control. A higher percentage of patients who underwent PMDI could perform SLR on POD 1; therefore, the functional recovery was earlier in the PMDI group than in the epidural catheter group. PMDI may suppress inflammation in the whole body because of steroids.

Tibiofemoral Contact After Conventional and High-Flexion Posterior Cruciate-Retaining Total Knee Arthroplasty

2003 ◽  
Author(s):  
Ephrat Most ◽  
Guoan Li ◽  
Harry E. Rubash
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Contact Point ◽  
Knee Kinematics ◽  
Testing System ◽  
High Flexion ◽  
Human Knee ◽  
Contact Points ◽  
Total Knee

The human knee is capable of flexing up to 160°, yet most patients do not achieve more than 120° after total knee arthroplasty (TKA). The translation of the tibiofemoral contact points with flexion is important in the overall understanding of knee kinematics and knee stability, particularly in high flexion. In this study, cadaveric knees were used in conjunction with a robotic testing system and TekScan® film to quantify the tibiofemoral contact between 0°–150° for two TKA designs. We found that, for both TKAs, with increasing knee flexion, the peak contact point moved posteriorly and that the contact area decreased with increasing knee flexion.

scholarly journals Comparison of Outcome and Gait Analysis after Robotic Total Knee Arthroplasty Between Mechanical and Kinematic Knee Alignment methods with and Average 8 Years Follow Up

10.29007/gclm ◽  
2018 ◽  
Author(s):  
Jong-Keun Seon ◽  
Eun-Kyoo Song ◽  
Dong-Hyun Lee ◽  
Je-Hyoung Yeo
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Kinematic Alignment ◽  
Functional Difference ◽  
Alignment Method ◽  
Knee Alignment ◽  
Significant Difference ◽  
Total Knee

Background: There are limited previous findings detailed biomechanical properties following implantation with mechanical and kinematic alignment method in robotic total knee arthroplasty (TKA) during walking. The purpose of this study was to compare clinical and radiological outcomes between two groups and gait analysis of kinematic, and kinetic parameters during walking to identify difference between two alignment method in robotic total knee arthroplasty.Methods: Sixty patients were randomly assigned to undergo robotic-assisted TKA using either the mechanical (30 patients) or the kinematic (30 patients) alignment method. Clinical outcomes including varus and valgus laxities, ROM, HSS, KSS and WOMAC scores and radiological outcomes were evaluated. And ten age and gender matched patients of each group underwent gait analysis (Optic gait analysis system composed with 12 camera system and four force plate integrated) at minimum 5 years post-surgery. We evaluated parameters including knee varus moment and knee varus force, and find out the difference between two groups.Results: The mean follow up duration of both group was 8.1 years (mechanical method) and 8.0 years (kinematic method). Clinical outcome between two groups showed no significant difference in ROM, HSS, WOMAC, KSS pain score at last follow up. Varus and valgus laxity assessments showed no significant inter-group difference. We could not find any significant difference in mechanical alignment of the lower limb and perioperative complicatoin. In gait analysis, no significant spatiotemporal, kinematic or kinetic parameter differences including knee varus moment (mechanical=0.33, kinematic=0.16 P&gt;0.5) and knee varus force (mechanical=0.34, kinematic=0.37 P&gt;0.5) were observed between mechanical and kinematic groups.Conclusions: The results of this study show that mechanical and kinematic alignment method provide comparable clinical and radiological outcomes after robotic total knee arthroplasty in average 8 years follow-up. And no functional difference were found between two knee alignment methods durning walking.

A Comparison of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty

2017 ◽  
Vol 31 (06) ◽  
pp. 568-572 ◽  
Author(s):  
Takanori Iriuchishima ◽  
Keinosuke Ryu
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Flexion Angle ◽  
Knee Flexion Angle ◽  
Significant Difference ◽  
Total Knee ◽  
And Control ◽  
Oxford Unicompartmental Knee Arthroplasty

AbstractThe purpose of this study was to compare the rollback ratio in bicruciate substituting (BCS) total knee arthroplasty (TKA) and bicruciate-retaining Oxford unicompartmental knee arthroplasty (UKA). In this study, 64 subjects (64 knees) undergoing BCS-TKA (Journey II: Smith and Nephew) and 50 subjects (50 knees) undergoing Oxford UKA (Zimmer-Biomet holdings, Inc., IN) were included. Approximately 6 months after surgery, and when the subjects had recovered their knee range of motion, following the Laidlow's method, lateral radiographic imaging of the knee was performed with active full knee flexion. The most posterior tibiofemoral contact point was measured for the evaluation of femoral rollback (rollback ratio). Flexion angle was also measured using the same radiograph and the correlation of rollback and flexion angle was analyzed. As a control, radiographs of the asymptomatic contralateral knees of subjects undergoing Oxford UKA were evaluated (50 knees). The rollback ratios of the BCS-TKA, Oxford UKA, and control knees were 37.9 ± 4.9, 35.7 ± 4.2, and 35.3 ± 4.8% respectively. No significant difference in rollback ratio was observed among the three groups. The flexion angles of the BCS-TKA, Oxford UKA, and control knees were 123.8 ± 8.4, 125.4 ± 7.5, and 127 ± 10.3 degrees, respectively. No significant difference in knee flexion angle was observed among the three groups. Significant correlation between rollback ratio and knee flexion angle was observed (p = 0.002; Pearson's correlation coefficient = − 0.384). BCS-TKA showed no significant difference in rollback ratio when compared with control knees and Oxford UKA knees. The BCS-TKA design is likely to reproduce native anterior cruciate ligament and posterior cruciate ligament function, and native knee rollback.

scholarly journals Do high flexion posterior stabilised total knee arthroplasty designs increase knee flexion? A meta analysis

2011 ◽  
Vol 35 (9) ◽  
pp. 1309-1319 ◽  
Author(s):  
Takanobu Sumino ◽  
Hemanth R. Gadikota ◽  
Kartik M. Varadarajan ◽  
Young-Min Kwon ◽  
Harry E. Rubash ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Meta Analysis ◽  
High Flexion ◽  
Total Knee

scholarly journals Improved knee flexion following high-flexion total knee arthroplasty

2012 ◽  
Vol 7 (1) ◽  
pp. 22 ◽  
Author(s):  
David R Lionberger ◽  
Mitchell D Eggers ◽  
Kathryn E Brewer ◽  
Li Fang
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
High Flexion ◽  
Total Knee

scholarly journals Improving Pre-Operative Flexion in Primary TKA: A Surgical Technique Emphasizing Knee Flexion with 5-Year Follow-Up

2014 ◽  
Vol 4 (2) ◽  
pp. 29-36
Author(s):  
Edward McPherson, MD FACS ◽  
Denise Portugal, MD ◽  
Matthew Dipane, BA ◽  
Sherif Sherif, MD
Keyword(s):  
Total Knee Arthroplasty ◽  
Surgical Technique ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Primary Total Knee Arthroplasty ◽  
Implant Design ◽  
Consecutive Series ◽  
High Flexion ◽  
Total Knee

This study prospectively reviews a consecutive series of 228 primary total knee arthroplasty (TKA) procedures utilizing a technique to optimize knee flexion.  The main features include: (1)the use of a “patellar friendly” femoral component and reduced thickness patellar components, (2) patient individualized adjustment of the femoral component rotation set strictly to the anterior-posterior femoral axis, (3)a rigorous flexion compartment debridement to remove non-essential posterior femoral bone with a Z-osteotome, and (4)incorporation of a rapid recovery protocol with features to promote knee flexion.Results were categorized into three groups: low pre-op flexion (90 degrees and below), regular pre-op flexion (91-125 degrees), and high pre-op flexion (126 degrees and above).  Average flexion in the low flexion group improved by 20 degrees at 6 weeks, 28 degrees at 3 months, 31 degrees at 1 year, and 30 degrees at 5 years.  In the regular flexion group, average flexion improved by 2 degrees at 6 weeks, 10 degrees at 3 months, 12 degrees at 1 year, and 13 degrees at 5 years.  Finally, in the high flexion group, average flexion decreased by 7 degrees at 6 weeks, regained preoperative levels at 3 months, and increased by 3 degrees at 1 year and 4 degrees at 5 years.In summary, a technique that emphasizes patellofemoral kinematics can consistently improve flexion in TKA in short and long-term follow-up.Keywords: Total knee arthroplasty, range of motion, high flexion, surgical technique, implant design, AP AxisLevel of Evidence:  AAOS Therapeutic Study Level III

Comparison of a vitamin E-infused highly crosslinked polyethylene insert and a conventional polyethylene insert for primary total knee arthroplasty at two years postoperatively

2019 ◽  
Vol 101-B (5) ◽  
pp. 559-564 ◽  
Author(s):  
S. Takemura ◽  
Y. Minoda ◽  
R. Sugama ◽  
Y. Ohta ◽  
S. Nakamura ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Vitamin E ◽  
Knee Arthroplasty ◽  
Study Group ◽  
Polyethylene Insert ◽  
Knee Prostheses ◽  
Radiological Results ◽  
Significant Difference ◽  
Total Knee ◽  
Clinical And Radiological Results

AimsThe use of vitamin E-infused highly crosslinked polyethylene (HXLPE) in total knee prostheses is controversial. In this paper we have compared the clinical and radiological results between conventional polyethylene and vitamin E-infused HXLPE inserts in total knee arthroplasty (TKA).Patients and MethodsThe study included 200 knees (175 patients) that underwent TKA using the same total knee prostheses. In all, 100 knees (77 patients) had a vitamin E-infused HXLPE insert (study group) and 100 knees (98 patients) had a conventional polyethylene insert (control group). There were no significant differences in age, sex, diagnosis, preoperative knee range of movement (ROM), and preoperative Knee Society Score (KSS) between the two groups. Clinical and radiological results were evaluated at two years postoperatively.ResultsDifferences in postoperative ROM and KSS were not statistically significant between the study and control groups. No knee exhibited osteolysis, aseptic loosening, or polyethylene failure. Additionally, there was no significant difference in the incidence of a radiolucent line between the two groups. One patient from the study group required irrigation and debridement, due to deep infection, at six months postoperatively.ConclusionClinical results were comparable between vitamin E-infused HXLPE inserts and conventional polyethylene inserts at two years after TKA, without any significant clinical failure. Cite this article: Bone Joint J 2019;101-B:559–564.

scholarly journals Early Spatiotemporal Patterns and Knee Kinematics during Level Walking in Individuals following Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Xubo Wu ◽  
Lixi Chu ◽  
Lianbo Xiao ◽  
Yong He ◽  
Shuyun Jiang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Gait Analysis ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Knee Kinematics ◽  
Gait Pattern ◽  
Swing Phase ◽  
Knee Flexion Angle ◽  
Total Knee ◽  
Support Time

Purpose. With the aim of investigating the spatiotemporal features of early gait pattern and knee kinematics after total knee arthroplasty and analyzing the association between outcomes of gait analyses and knee kinematic parameters, the relationship between walking and dynamic knee deformity at the early period after total knee arthroplasty was assessed in this study. Methods. Eighteen patients including 14 women and 4 men who underwent total knee arthroplasty were analyzed using three-dimensional gait analysis system to observe gait parameters and values of maximum knee flexion angle (MKFA) during swing phase and knee flexion angle (KFA) and knee valgus angle (KVA) at midstance phase. Results. 3D gait analysis showed that operated side exhibited significantly less total support time and single support time as well as significantly longer swing phase compared with the other side. During walking, the operated side had significantly smaller MKFA and greater KFA and KVA than the nonoperated side. There was moderate to significant correlation between gait pattern and the dynamic knee kinematics. Conclusion. The gait abnormality of patients after TKA was associated with inadequate flexion of knees at swing phase and insufficient extension at stance phase as well as increased range of valgus.

Effect of Manipulation under Anesthesia of the First Knee in Staged Bilateral Total Knee Arthroplasty on Clinical Outcome and Satisfaction

2020 ◽  
Author(s):  
Jung-Won Lim ◽  
Yong-Beom Park ◽  
Dong-Hoon Lee ◽  
Han-Jun Lee
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Knee Flexion ◽  
Functional Score ◽  
Manipulation Under Anesthesia ◽  
Total Knee

AbstractThis study aimed to evaluate whether manipulation under anesthesia (MUA) affect clinical outcome including range of motion (ROM) and patient satisfaction after total knee arthroplasty (TKA). It is hypothesized that MUA improves clinical outcomes and patient satisfaction after primary TKA. This retrospective study analyzed 97 patients who underwent staged bilateral primary TKA. MUA of knee flexion more than 120 degrees was performed a week after index surgery just before operation of the opposite site. The first knees with MUA were classified as the MUA group and the second knees without MUA as the control group. ROM, Knee Society Knee Score, Knee Society Functional Score, Western Ontario and McMaster Universities (WOMAC) score, and patient satisfaction were assessed. Postoperative flexion was significantly greater in the MUA group during 6 months follow-up (6 weeks: 111.6 vs. 99.8 degrees, p < 0.001; 3 months: 115.9 vs. 110.2 degrees, p = 0.001; 6 months: 120.2 vs. 117.0 degrees, p = 0.019). Clinical outcomes also showed similar results with knee flexion during 2 years follow-up. Patient satisfaction was significantly high in the MUA group during 12 months (3 months: 80.2 vs. 71.5, p < 0.001; 6 months: 85.8 vs. 79.8, p < 0.001; 12 months: 86.1 vs. 83.9, p < 0.001; 24 months: 86.6 vs. 85.5, p = 0.013). MUA yielded improvement of clinical outcomes including ROM, and patient satisfaction, especially in the early period after TKA. MUA in the first knee could be taken into account to obtain early recovery and to improve patient satisfaction in staged bilateral TKA.

Sign in / Sign up

Export Citation Format

Share Document