scholarly journals Plain Radiographs Can Safely Be Used to Measure and Follow Up on Tibial Component Alignment in Unicondylar Knee Replacement: A Correlation Study With CT Scans

Cureus ◽  
2021 ◽  
Author(s):  
Enejd Veizi ◽  
Nurdan Çay ◽  
Şahan Güven ◽  
Ali Şahin ◽  
Ahmet Fırat ◽  
...  
Keyword(s):  
Knee Replacement ◽  
Tibial Component ◽  
Correlation Study ◽  
Ct Scans ◽  
Component Alignment ◽  
Plain Radiographs ◽  
Unicondylar Knee Replacement ◽  
Tibial Component Alignment

DOES NAVIGATION TOTAL KNEE REPLACEMENT REALLY MAKE A DIFFERENCE?

2013 ◽  
Vol 16 (02) ◽  
pp. 1350007
Author(s):  
P. Motwani ◽  
A. Jariwala ◽  
N. Valentine
Keyword(s):  
Total Knee Replacement ◽  
Tibial Component ◽  
Sagittal Plane ◽  
Computer Navigation ◽  
Component Alignment ◽  
Tibial Component Alignment ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean

Background: Computer Navigation in Total Knee Replacement (TKR) has completed more than a decade since its inception. From that time, numerous studies have been done to see its effect on the variables of surgery and its outcome. Some studies have shown that it is definitely beneficial while others have negated its superiority over conventional techniques. This is an early outcome study on the results of navigation TKR in terms of alignment and clinical outcome at three years post-operatively. Methods: In the present study, 128 patients who had undergone navigation TKR (128 TKR) between January 2006 and November 2009 were included. The navigation system used was orthoPilot®. Patients were assessed post-operatively at one and three year using knee society score (KSS) and knee function score (KFS). All patients completed one year follow-up and 55 patients completed three year follow-up. From 128 patients, 40 navigated TKR patients operated between November 2007 and 2009 and were compared with 40 patients operated by conventional TKR operated between July 2007 and December 2008. Results: The mean KSS at 1 year post-operatively was 85.60 and at 3 years was 85.87. The mean KFS at 1 year post-operatively was 69.30 and at 3 years was 68.00. There was no statistically significant difference between navigation TKR and conventional TKR in terms of anatomical femoro-tibial alignment, femoral component alignment in coronal and sagittal plane and tibial component alignment in coronal plane. However, there was statistically significant difference between tibial component alignment in sagittal plane (p = 0.000) between both the groups. Conclusion: Computer navigation TKR affords a possibility to place both the femoral and tibial component very precisely without the risk of any greater axis deviation from ideal value. It helps in reducing the outliers in alignment of the limb and that of component and that improves the overall implant survival for a long time post-operatively.

Benefits of CT Scanning for the Management of Knee Arthritis and Arthroplasty

2020 ◽  
Author(s):  
Nipun Sodhi ◽  
David J. Jacofsky ◽  
Alexander Chee ◽  
Michael A. Mont
Keyword(s):  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Patellofemoral Joint ◽  
Ct Scans ◽  
Component Alignment ◽  
Knee Arthritis ◽  
Plain Radiographs ◽  
Tissue Protection ◽  
Joint Assessment ◽  
Knee Compartments

AbstractThis review investigated the potential value of computed tomography (CT) scans for the evaluation and management of knee arthritis and arthroplasty. Specifically, we evaluated the following: (1) assessment of arthritis within knee compartments, (2) patellofemoral joint assessment, (3) implant sizing prediction, (4) component alignment, (5) soft-tissue protection, and (6) potential concerns with radiation exposure. To compare if CT or X-ray imaging is more accurate and clinically relevant, a search was performed using Boolean search operators and terms: “CT,” “radiograph,” “joint alignment,” “knee,” and “arthroplasty,” which yielded 661 results. Studies were evaluated based on (1) assessment of arthritis within knee compartments, (2) patellofemoral joint assessment, (3) implant sizing prediction, (4) component alignment, (5) soft-tissue protection, and (6) potential concerns with radiation exposure. Correlative and comparative analyses of imaging modalities to pre-, intra-, and postoperative clinical and patient-related factors were performed for the 63 included studies. CT scans were found to better detect medial and lateral arthritic changes, bony deformities, subchondral cysts, and cartilage losses. CT scans were shown to 99% accurately predict prosthetic sizes preoperatively. CT scans can also help better visualize surrounding anatomy, such as the posterior cruciate ligament, and have therefore been linked to better soft tissue protection during total knee arthroplasty. Although radiation is a potential concern, newer imaging protocols have comparable exposure to plain radiographs. Compared with plain radiographs, CT scans were found to be more accurate and provide more clinically relevant data. Therefore, the authors recommend the use of CT for the evaluation of certain patients with arthritis and for preoperative planning for knee arthroplasty.

Efficacy of Portable Accelerometer-Based Navigation Devices versus Conventional Guides in Total Knee Arthroplasty: A Meta-analysis

2019 ◽  
Vol 33 (07) ◽  
pp. 691-703 ◽  
Author(s):  
Han Sun ◽  
Shuxiang Li ◽  
Kun Wang ◽  
Guofeng Wu ◽  
Jian Zhou ◽  
...  
Keyword(s):  
Tibial Component ◽  
Operative Time ◽  
Short Form ◽  
Meta Analysis ◽  
Mechanical Alignment ◽  
Knee Score ◽  
Component Alignment ◽  
Posterior Slope ◽  
Tibial Component Alignment ◽  
Total Knee

AbstractVarious studies have provided different conclusions regarding which component's alignment can be actually improved by a novel portable accelerometer-based navigation device (PAD) compared with the conventional guide (CON); the operative times and clinical outcomes reported by these studies also exhibited incongruity. Thus, this meta-analysis was conducted to evaluate the efficacy of PADs in total knee arthroplasty (TKA). The Web of Science, EMBASE, PubMed, MEDLINE, and Cochrane Library databases were systematically searched. Studies published till July 2018 and comparing PAD with CON in treatment with TKA were identified. Sixteen studies in which 1,551 TKAs were reported were included. Results showed that PAD was significantly superior to CON in reducing tibial component alignment out of ±3 degrees, femoral coronal angle out of ±3 degrees, and overall mechanical alignment out of ±3 degrees. PAD can also help obtain a more accurate result of femoral coronal angle (degree); however, it requires a longer operative time than the CON group. The two groups were comparable in tibial component alignment out of ±2 degrees, tibial component posterior slope out of ±3 degrees, tibial component posterior slope out of ±2 degrees, femoral coronal angle out of ±2 degrees, femoral sagittal angle out of ±3 degrees, femoral sagittal angle out of ±2 degrees, tibial component alignment (degree), tibial component posterior slope (degree), femoral sagittal angle (degree), overall mechanical alignment (degree), blood loss, Knee Society knee score, Knee Society function score, Oxford Knee Score, Short Form-36 physical component score, Short Form-36 mental component score, and range of motion. In conclusion, compared with CON, PAD can help improve the femoral coronal angle as well as decrease the outliers out of ±3 degrees in femoral/tibial coronal angles and overall mechanical alignment. However, PAD did not show significant advantages in tibial and femoral component sagittal angles out of ±3 degrees, various outliers of ±2 degrees, most mean values of component alignments, operative time, and various functional or satisfactory scores.

scholarly journals Primary total knee replacement using dished polyethylene with resected posterior cruciate ligament

2021 ◽  
Vol 7 (4) ◽  
pp. 781
Author(s):  
Mohan M. Kumar ◽  
Satvik N. Pai ◽  
Pravin K. Vanchi ◽  
Raghav Ravi ◽  
Syam Nath
Keyword(s):  
Total Knee Replacement ◽  
Posterior Cruciate Ligament ◽  
Knee Replacement ◽  
Tibial Component ◽  
Cruciate Ligament ◽  
Womac Score ◽  
Senior Author ◽  
Kaplan Meier ◽  
Total Knee

<p><strong>Background: </strong>The choice between preserving, sacrificing or substituting the posterior cruciate ligament (PCL) is always a controversial topic in total knee replacement (TKR). Dished polyethylene insert with PCL resection enables correction of the commonly present fixed flexion and varus deformities. Additionally, the risk of premature wear of polyethylene is less because of the confirming articular geometry between the femoral and tibial component.<strong></strong></p><p><strong>Methods: </strong>This is a retrospective study in which we studied 120 knees in 95 consecutive patients undergoing primary TKR by the senior author at our institute. We used TKR system with dished metal backed polyethylene tibial component. PCL resection was performed in all cases. Pre-operative and post-operative functional assessment were done using knee society clinical scores and Western Ontario and McMaster universities osteoarthritis index (WOMAC). All radiographs were assessed using the knee society Roentgenographic scoring system (KSRES). Statistical analysis was performed using paired student t tests. Survivorship was determined using Kaplan-Meier survivorship curves. <strong></strong></p><p><strong>Results: </strong>Mean follow-up was 8 years. Range of motion increased from 75 degrees to 110 degrees.  The knee society pain score increased from 30 to 94. The knee society function score increased from 35 to 75. WOMAC score increased in terms of pain, stiffness and physical function.<strong></strong></p><p><strong>Conclusions: </strong>We conclude that deep dish bearing is a viable option in presence of deficient PCL and provides adequate stability and functional outcome. We need a larger sample size, multicentre trial and longer follow-up to see for complication rate, revision rate and survival.</p>

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