scholarly journals A Comparison of Patient Outcomes Following Prosthetic Knee Replacement Using a Variety of Knee Prosthesis: A Ten-Year Study

2014 ◽  
Vol 04 (09) ◽  
pp. 249-256
Author(s):  
Bassel El-Osta ◽  
Ali Ghoz ◽  
Alice Dawson ◽  
Mark Andrews
Keyword(s):  
Patient Outcomes ◽  
Knee Replacement ◽  
Knee Prosthesis ◽  
Prosthetic Knee

scholarly journals Analysis of Friction in Total Knee Prosthesis during a Standard Gait Cycle

Lubricants ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 36
Author(s):  
Matúš Ranuša ◽  
Markus A. Wimmer ◽  
Spencer Fullam ◽  
Martin Vrbka ◽  
Ivan Křupka
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Computational Models ◽  
Gait Cycle ◽  
Knee Prosthesis ◽  
Shear Stresses ◽  
Cobalt Chromium ◽  
Joint Friction ◽  
The Coefficient Of Friction ◽  
Total Knee

Total knee arthroplasty is on the rise worldwide. Despite its success, revision surgeries are also increasing. According to the American Joint Replacement Registry 2020, 3.3% of revision surgeries are due to wear, and 24.2% are due to mechanical loosening. The combination of shear stresses and wear particles occurring at the bone/implant interface can lead to local osteolysis. Although the shear stresses are partially driven by joint friction, relatively little is known about the evolution of the coefficient of friction (CoF) during a gait cycle in total knee replacement. Here we describe the CoF during a gait cycle and investigate its association with kinematics (slide–roll-ratio), applied load, and relative velocity. The artificial knee was simulated by cobalt–chromium condyle on a flat ultra-high-molecular-weight polyethylene (UHMWPE) tibial plateau, lubricated by either water or proteinaceous solution. We found that the CoF is not a constant but fluctuates between the values close to 0 and 0.15. Cross-correlation suggested that this is primarily an effect of the slide–roll ratio and the contact pressure. There was no difference in the CoF between water and proteinaceous solution. Knowledge about the CoF behavior during a gait cycle will help to increase the accuracy of future computational models of total knee replacement.

Mobility and Stability of the Intact and Replaced Knee

2015 ◽  
Author(s):  
John Goodfellow ◽  
John O'Connor ◽  
Hemant Pandit ◽  
Christopher Dodd ◽  
David Murray
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Final Section ◽  
Sagittal Plane ◽  
Polyethylene Wear ◽  
Mobile Bearing ◽  
Theoretical Background ◽  
Cruciate Retaining ◽  
Prosthetic Knee ◽  
Total Knee

Having demonstrated in Chapter 2 that a fully conforming mobile bearing can minimise polyethylene wear, in this chapter we show that a mobile bearing prosthesis, unconstrained in the sagittal plane, can restore natural mobility and stability. For surgeon readers who are less interested in the theoretical background, it might be advisable to go straight to Chapter 4, Indications, or to start by reading the final section of this chapter, The Loaded Prosthetic Knee. If that proves interesting, the surgeon might attempt The Unloaded Prosthetic Knee. For the more research minded surgeon or engineer, it seems more logical to start with the Unloaded Natural Knee (the longest section of the chapter) and to read from there. The chapter may also be of interest to those surgeons embarking on the use of a bi-cruciate retaining total knee replacement.

scholarly journals Single postoperative infusion of zoledronic acid to improve patient-reported outcome after hip or knee replacement: study protocol for a randomised, controlled, double-blinded clinical trial

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e040985
Author(s):  
Jonathan Brandt ◽  
Håkan Ledin ◽  
Jonas Ranstam ◽  
Ewa Roos ◽  
Per Aspenberg ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Zoledronic Acid ◽  
Knee Replacement ◽  
Knee Prosthesis ◽  
Patient Reported Outcome ◽  
Ethical Review ◽  
Outcome Score ◽  
Patient Reported ◽  
Double Blinded ◽  
Improve Patient

IntroductionIn Sweden, roughly 3000 patients are reoperated each year due to pain and loss of function related to a loosened hip or knee prosthesis. These reoperations are strenuous for the patient, technically demanding and costly for the healthcare system. Any such reoperation that can be prevented would be of great benefit. Bisphosphonates are drugs that inhibit osteoclast function. Several clinical trials suggest that bisphosphonates lead to improved implant fixation and one small study even indicates better functional outcome. Furthermore, in epidemiological studies, bisphosphonates have been shown to decrease the rate of revision for aseptic loosening by half. Thus, there are several indirect indications that bisphosphonates could improve patient-reported outcome, but no firm evidence.Methods and analysisThis is a pragmatic randomised, placebo-controlled, double-blinded, academic clinical trial of a single postoperative dose of zoledronic acid, in patients younger than 80 years undergoing primary total hip or knee replacement for osteoarthritis. Participants will be recruited from two orthopaedic departments. All surgeries will be performed, and study drugs given at Motala Hospital, Sweden. The primary endpoint is to investigate between-group differences in the Hip dysfunction and Osteoarthritis Outcome Score and the Knee injury and Osteoarthritis Outcome Score at 3-year follow-up. Secondary outcomes will be investigated at 1 year, 3 years and 6 years, and stratified for hip and knee implants. These secondary endpoints are supportive, exploratory or explanatory. A total of 1000 patients will be included in the study.Ethics and disseminationThe study has been approved by the Regional Ethical Review Board in Linköping (DNR 2015/286-31). The study will be reported in accordance with the Consolidated Standards of Reporting Trials statement for pharmacological trials. The results will be submitted for publication in peer-reviewed academic journals and disseminated to patient organisations and the media.Trial registration numberEudraCT: No 2015-001200-55; Pre-results.

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