scholarly journals Preoperative Radiological Assessment of The Total Knee Arthroplasty

2021 ◽  
Author(s):  
Atilla Hikmet Cilengir ◽  
Suat Dursun ◽  
Kazım Ayberk Sinci ◽  
Özgür Tosun
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Preoperative Imaging ◽  
Radiographic Evaluation ◽  
Prosthetic Material ◽  
Total Knee ◽  
Severity Of The Disease ◽  
Implant Alignment

Total knee arthroplasty (TKA) is a surgery method that can reduce symptoms and restore joint functions. Long-term success of this operation depends on the correct anatomical and mechanical planning before the prosthetic material implantation. Accurate implant alignment together with anatomical balance provides more successful clinical outcomes and longer duration of the prosthetic material. Improper preoperative planning may cause implant loosening and increased load on the knee joint. Conventional radiographs are the most frequently used imaging methods for this purpose. Computed tomography and magnetic resonance imaging may be used in required cases. In addition, computer-aided systems have come into use and successful results have been reported. Early radiographic evaluation is unnecessary after an uncomplicated TKA. Preoperative imaging has several aims such as to assess the severity of the disease, to analyze the reserve bone tissue, to review the relevant anatomy, and to decide which implant and surgical approach will be applied. In this article, we aimed to present the necessary and also auxiliary radiological evaluations made before TKA in order to achieve better clinical results.

scholarly journals Radiographic evaluation of tibial component alignment in total knee arthroplasty following extramedullary and intramedullary tibial referencing

2017 ◽  
Vol 3 (6) ◽  
pp. 1199
Author(s):  
B. Harikrishnan ◽  
Anjan Prabhakara ◽  
Gururaj R. Joshi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Radiographic Evaluation ◽  
Component Alignment ◽  
Tibial Component Alignment ◽  
Knee Deformity ◽  
Total Knee ◽  
The Difference

<p class="abstract"><strong>Background:</strong> Long term survivorship of total knee arthroplasty (TKA) is significantly dependant on prostheses alignment. The debate on optimal referencing for femoral component is largely resolved with Intra-medullary jigs reproducing superior alignment. However there is still a contention about whether intramedullary or extramedullary jigs are better for tibial referencing. This study aims to compare the accuracy of tibial component alignment in TKA using intramedullary and extramedullary tibial referencing jigs.</p><p class="abstract"><strong>Methods:</strong> Between December 2012 and September 2014, 66 primary conventional cemented TKAs were performed using Nexgen-LPS Flex (Zimmer) implants in 55 patients, 50-80 y old (mean 65.54 y) with osteoarthritis/rheumatoid arthritis. Intramedullary and extramedullary tibial referencing was used in alternate patients undergoing TKA after excluding patients with BMI <span style="text-decoration: underline;">&gt;</span>35 kg/m<sup>2</sup>, knee deformity <span style="text-decoration: underline;">&gt;</span>15<sup>0</sup>,excessive tibial bowing, previous fractures/surgeries/retained metalwork around knee. Postoperatively, tibial component alignment (TCA) in coronal plane was assessed using AP radiograph of leg. A 3<sup>º</sup> cutoff from neutral mechanical axis (i.e., 90<sup>o</sup>±3<sup>o</sup>) was considered acceptable.<strong></strong></p><p class="abstract"><strong>Results:</strong> The intramedullary group (n=33) had 4 outliers (TCA &gt;93<sup>º</sup> or &lt;87<sup>º</sup>) whereas the extramedullary group (n=33) had 7 outliers (p=0.511). The difference in mean TCA between intramedullary and extramedullary groups was not statistically significant [90.70±2.43 and 90.55±2.17 (p=0.790)]. There were no significant per-operative/post-operative complications in either group.</p><p><strong>Conclusions:</strong> We conclude that both intramedullary and extramedullary tibial referencing guides can be used to achieve desired tibial component alignment (90±3<sup>º</sup>) in TKA. However the surgeon should appreciate the benefits and deficiencies of either types of tibial referencing and use whichever is suited in a particular case. </p>

scholarly journals Minimally invasive surgery total knee arthroplasty is less popular, but the prosthesis designed specifically for MIS provides good survival and PROMs with a minimum follow-up of 10 years

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Shinya Toyoda ◽  
Takao Kaneko ◽  
Yuta Mochizuki ◽  
Masaru Hada ◽  
Kazutaka Takada ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Knee Arthroplasty ◽  
Invasive Surgery ◽  
Clinical Results ◽  
Good Survival ◽  
Total Knee

Abstract Background The concept of minimally invasive surgery (MIS) was introduced in total knee arthroplasty (TKA) in the late 1990s. The number of MIS TKAs has clearly decreased in recent years. An implant designed specifically for MIS TKA has been used all over the world, but there are no reports of long-term postoperative results. The purpose of this study was to characterize long-term clinical results with a minimum follow-up of 10 years. Methods This retrospective study included 109 consecutive patients with 143 NexGen CR-Flex prostheses, which are MIS tibial component prostheses designed specifically for MIS TKA. Twelve-year survival analysis was performed using Kaplan-Meier method. Revision surgery for any reason was the endpoint. Long-term clinical and radiographic results of 74 knees (55%) in 60 patients with more than 10 years of follow-up were analyzed. Results The cumulative survival rate of the single-radius posterior-stabilized TKA of 74 knees was 94.7% (95% confidence interval, 90–99%) at 12 years after surgery. Seven knees (9%) required additional surgery during the 10-year follow-up because of periprosthetic infections. Mean postoperative Knee Society knee score and functional score were 91 and 74 points, respectively. There were no cases of prosthesis breakage, polyethylene wear, or aseptic loosening of the prosthesis. Conclusion The prosthesis designed specifically for MIS TKA is associated with good survival and clinical results with a minimum follow-up of 10 years, even though MIS TKA has become less popular. Level of evidence III

Isolated Liner Revision for Total Knee Arthroplasty Instability: A Road That Should Remain Less Taken

2020 ◽  
Author(s):  
Jason D. Tegethoff ◽  
Rafael Walker-Santiago ◽  
William M. Ralston ◽  
James A. Keeney
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
P Value ◽  
Surgical Morbidity ◽  
Exact Test ◽  
Total Knee ◽  
Component Revision

AbstractIsolated polyethylene liner exchange (IPLE) is infrequently selected as a treatment approach for patients with primary total knee arthroplasty (TKA) prosthetic joint instability. Potential advantages of less immediate surgical morbidity, faster recovery, and lower procedural cost need to be measured against reoperation and re-revision risk. Few published studies have directly compared IPLE with combined tibial and femoral component revision to treat patients with primary TKA instability. After obtaining institutional review board (IRB) approval, we performed a retrospective comparison of 20 patients treated with IPLE and 126 patients treated with tibial and femoral component revisions at a single institution between 2011 and 2018. Patient demographic characteristics, medical comorbidities, time to initial revision TKA, and reoperation (90 days, <2 years, and >2 years) were assessed using paired Student's t-test or Fisher's exact test with a p-value <0.01 used to determine significance. Patients undergoing IPLE were more likely to undergo reoperation (60.0 vs. 17.5%, p = 0.001), component revision surgery (45.0 vs. 8.7%, p = 0.002), and component revision within 2 years (30.0 vs. 1.6%, p < 0.0001). Differences in 90-day reoperation (p = 0.14) and revision >2 years (p = 0.19) were not significant. Reoperation for instability (30.0 vs. 4.0%, p < 0.001) and infection (20.0 vs. 1.6%, p < 0.01) were both higher in the IPLE group. IPLE does not provide consistent benefits for patients undergoing TKA revision for instability. Considerations for lower immediate postoperative morbidity and cost need to be carefully measured against long-term consequences of reoperation, delayed component revision, and increased long-term costs of multiple surgical procedures. This is a level III, case–control study.

Varus alignment of the tibial component up to seven degrees is not associated with poor long-term outcomes in a neutrally aligned total knee arthroplasty

2021 ◽  
Author(s):  
Francisco Antonio Miralles-Muñoz ◽  
Marta Rubio-Morales ◽  
Laiz Bello-Tejada ◽  
Santiago González-Parreño ◽  
Alejandro Lizaur-Utrilla ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tibial Component ◽  
Varus Alignment ◽  
Long Term Outcomes ◽  
Total Knee

scholarly journals Long-term survival and radiological results of the Duracon™ total knee arthroplasty

2013 ◽  
Vol 38 (4) ◽  
pp. 747-752 ◽  
Author(s):  
Matthias Bachmann ◽  
Lilianna Bolliger ◽  
Thomas Ilchmann ◽  
Martin Clauss
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Term Survival ◽  
Long Term Survival ◽  
Radiological Results ◽  
Total Knee
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