Comparison of Femoral Rotation in Total Knee Arthroplasty with Measured Resection Technique and Balanced Flexion Gap Technique

10.5580/2b82 ◽  
2012 ◽  
Vol 19 (2) ◽  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Rotation ◽  
Flexion Gap ◽  
Gap Technique ◽  
Measured Resection ◽  
Total Knee

Different femoral rotation with navigated flexion-gap balanced or measured resection in total knee arthroplasty does not lead to different clinical outcomes

2019 ◽  
Vol 28 (6) ◽  
pp. 1805-1813 ◽  
Author(s):  
José A. Hernández-Hermoso ◽  
Lexa Nescolarde-Selva ◽  
David Rodríguez-Montserrat ◽  
Juan C. Martínez-Pastor ◽  
Ester García-Oltra ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Femoral Rotation ◽  
Flexion Gap ◽  
Measured Resection ◽  
Total Knee

scholarly journals Accuracy of total knee arthroplasty using the modified gap technique based on the bone gap: an evaluation of the bone gap with a distal femoral trial component

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Goki Kamei ◽  
Shigeki Ishibashi ◽  
Koki Yoshioka ◽  
Satoru Sakurai ◽  
Hiroyuki Inoue ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Distal Femur ◽  
Gap Size ◽  
Flexion Gap ◽  
Gap Technique ◽  
Joint Gap ◽  
Total Knee ◽  
The Mean

Abstract Background In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance is measured after osteotomy of the distal femur and proximal tibia (conventional bone gap). However, after osteotomy, the flexion gap size during 90° knee flexion may be larger than that observed after implantation. The tension of the lateral compartment during 90° flexion may also be reduced after osteotomy of the distal femur. We manufactured a distal femoral trial component to reproduce the condition after implantation and prior to posterior condyle osteotomy. This study aimed to evaluate the effect of the trial component on the flexion gap. Methods This prospective study included 21 consecutive patients aged 78 years with medial osteoarthritis who underwent cruciate-retaining TKA between February 2017 and March 2018. The postoperative flexion gap size and inclination during 90° flexion were compared between cases with and without the trial component. Results The mean joint gap size with the trial component (13.4 ± 0.80 mm) was significantly smaller than that without the trial component (14.7 ± 0.84 mm). The mean gap inclination angle with the trial component (3.7° ± 0.62°) was significantly smaller than that without the trial component (5.5° ± 0.78°). Conclusions In the present study, the joint gap size and medial tension were significantly reduced after the trial component had been set. Accurate measurement of the soft-tissue balance is an important factor in the modified gap technique, and this method using a distal femoral trial component can offer better outcomes than those achieved with conventional methods.

The flexion gap preparation does not disturb the modified gap technique in posterior stabilized total knee arthroplasty

The Knee ◽  
2012 ◽  
Vol 19 (6) ◽  
pp. 832-835 ◽  
Author(s):  
Yukihide Minoda ◽  
Hiroyoshi Iwaki ◽  
Mitsuhiko Ikebuchi ◽  
Taku Yoshida ◽  
Hiroaki Nakamura
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Posterior Stabilized ◽  
Flexion Gap ◽  
Gap Technique ◽  
Total Knee

Neither Anterior nor Posterior Referencing Consistently Balances the Flexion Gap in Measured Resection Total Knee Arthroplasty: A Computational Analysis

2019 ◽  
Vol 34 (5) ◽  
pp. 981-986.e1 ◽  
Author(s):  
Shady S. Elmasry ◽  
Carl W. Imhauser ◽  
Timothy M. Wright ◽  
Andrew D. Pearle ◽  
Michael B. Cross ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computational Analysis ◽  
Flexion Gap ◽  
Measured Resection ◽  
Total Knee

scholarly journals Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique

2013 ◽  
Vol 38 (3) ◽  
pp. 531-537 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Hirotsugu Muratsu ◽  
Yohei Kawakami ◽  
Koji Takayama ◽  
Kazunari Ishida ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Cruciate Retaining ◽  
Soft Tissue Balancing ◽  
Gap Technique ◽  
Measured Resection ◽  
Total Knee

A STUDY TO COMPARE FIXED BEARING AND MOBILE BEARING TOTAL KNEE ARTHROPLASTY IN TERTIARY MEDICAL CENTRE, MUMBAI

2021 ◽  
pp. 42-44
Author(s):  
Amol K Salve ◽  
Vinod Kumar Yadav ◽  
Ajay M Wankhade ◽  
Tanay Nahatkar ◽  
Sangam Jain
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Articular Surface ◽  
Mobile Bearing ◽  
Inclusion Criteria ◽  
Medical College ◽  
Flexion Gap ◽  
Total Knee

Intro- For TKA, there are two types of bearing designs: xed-bearing and mobile-bearing. Round femoral components articulate with a relatively at tibial articular surface in a xed-bearing knee design. Because the insert does not hinder the natural movements of the femoral component, the mobile-bearing (MB) TKA design is thought to allow more exibility of motion than the xed-bearing (FB) variety. Aim and objective: To compare xed bearing and mobile bearing total knee arthroplasty. Material and methods:This study is a prospective type of study done at Seth GS medical college Mumbai, Department of Orthopaedics during August 2019 to June 2021 on patients undergoing total knee arthroplasty. Patients who were to undergo total knee arthroplasty were invited to take part in the study. This study, done on them was explained in detail to them. An informed consent was obtained. Patients fullling the inclusion criteria were listed. Result: Range of motion achieved after mobile arthroplasty was 123.62±2.94 and in xed arthroplasty it was 121.96±2.74. Pain after last follow up in mobile arthroplasty was 48.83±0.62 and for xed arthroplasty was 47.39±0.86. Flexion gap after last follow up in mobile arthroplasty was 24.13±0.45 and in xed was 24.02±0.45. Stability was almost similar in both mobile and xed arthroplasty. Conclusions: there is no signicant difference between xed arthroplasty and mobile arthroplasty as far as Range of motion, Pain ,Flexion gap. Stability was almost similar in both mobile and xed arthroplasty.

Patient Variation Limits Use of Fixed References for Femoral Rotation Component Alignment in Total Knee Arthroplasty

2018 ◽  
Vol 33 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Joshua G. Twiggs ◽  
David M. Dickison ◽  
Elizabeth C. Kolos ◽  
Caitlin E. Wilcox ◽  
Justin P. Roe ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Femoral Rotation ◽  
Component Alignment ◽  
Total Knee ◽  
Rotation Component

scholarly journals Why knees move like they do: A simulation of the effect of varying distal femoral and proximal tibial anatomy on coronal kinematic curve morphology

2017 ◽  
Vol 5 (5_suppl5) ◽  
pp. 2325967117S0016
Author(s):  
Peter McEwen
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Proximal Tibia ◽  
Coronal Plane ◽  
Curve Shape ◽  
Femoral Rotation ◽  
Full Extension ◽  
Reciprocal Effect ◽  
Maximal Deviation ◽  
Total Knee

Objective: Computer assisted total knee arthroplasty (CA TKA) platforms can provide detailed kinematic data that is presented in various forms including a coronal plane graphic that maps the flexion arc from full extension to deep flexion. Graphics obtained from normal tibiofemoral articulations reveal varied and complex kinematic patterns that have yet to be explained. An understanding of what drives curve variation would allow prediction of how a preoperative curve would be altered by total knee arthroplasty. Implant position could then be tailored to maintain a desirable curve or avoid an undesirable one. Methods: An articulated lower limb saw bone with a stable hip pivot was obtained. Adjustable osteotomies were created so that femoral torsion, femoral varus-valgus and tibial varus-valgus could be altered independently. The saw bone limb was registered with a CA TKA navigation system using the posterior condyles as a rotational axis. Axial and coronal plane morphology of the distal femur and coronal plane morphology of the proximal tibia were systematically altered and a kinematic curve obtained for each morphologic combination. Femoral rotational position was varied from 100 of internal torsion to 100 of external torsion in 20 increments. Similarly, femoral coronal position was varied from 20 of varus to 60 of valgus and tibial coronal position was varied from 5.50 of varus to 10 of valgus. Curves were obtained by manually flexing the joint through a full range of motion with the femoral condyles in contact with proximal tibia at all times. Results: Varying femoral rotation has no effect in full extension but drives the curve away from neutral as the knee flexes. Maximal deviation is seen at around 900 of flexion. Internal torsion drives the curve into valgus as the knee flexes and external torsion has a reciprocal effect. Varying femoral varus-valgus causes maximal deviation from neutral in full extension. Femoral varus drives the curve from varus in extension towards valgus as the knee flexes with the effect peaking in maximal flexion. Femoral valgus has a reciprocal effect. Varying tibial varus-valgus has no effect on curve shape but does move the curve either side of neutral. Complex (parabolic) curves are caused by large rotations or the opposing effects of femoral varus-valgus and femoral rotation. The modal human anatomy of slight femoral internal rotation, slight femoral valgus and slight tibial varus produces a straight neutral curve. Conclusion: Kinematic curve shape is driven by distal femoral anatomy. The typical changes made to distal femoral articular anatomy in TKA by externally rotating a neutrally orientated femoral component will bring many native curves towards neutral. Externally rotating when the preoperative curve begins neutral and drives into varus as the knee flexes will drive the curve harder into varus. Conversely, kinematic femoral placement will reconstitute the premorbid curve morphology. Which outcome is preferable has yet to be determined.

scholarly journals The Influence of Femoral Internal Rotation on Patellar Tracking in Total Knee Arthroplasty using Gap Technique

2021 ◽  
Vol 13 ◽  
Author(s):  
Dong Oh Ko ◽  
Song Lee ◽  
Jin Hak Kim ◽  
Il Chan Hwang ◽  
Sung Jun Jang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Internal Rotation ◽  
Knee Arthroplasty ◽  
Patellar Tracking ◽  
Gap Technique ◽  
Total Knee
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