No difference in clinical outcome but in RSA in total knee arthroplasty with the ATTUNE vs. the PFC Sigma: a randomized trial with 2-year follow-up.

Background And Purpose: Despite usage of the ATTUNE total knee arthroplasty (TKA) for about 10 years, few randomized trials exist. We evaluated whether the ATTUNE CR design showed improved clinical results compared with the PFC Sigma CR after 2 years and if there was a difference in tibial component migration.

Patients And Methods: 96 patients with knee osteoarthritis were randomly treated with cemented ATTUNE or PFC Sigma TKA.

Gluteus Maximus Transfer following Total Hip Arthroplasty Does Not Improve Abductor Moment: A Case-Control Gait Analysis Study of 15 Patients with Gluteus Medius Disruption.

Gluteus maximus flap transfer (GMT) is a surgical technique used to improve gait kinematics and kinetics, as well as to reduce and ameliorate the functional outcome in patients with hip abductor deficiency following total hip arthroplasty (THA). The purpose of this observational study was to evaluate the gait pre- and postoperatively and examine whether GMT increases the abduction moment. Materials and Methods: A gait analysis based on reflective markers and force plates was performed in 15 patients who underwent GMT and were examined using an optical tracking system before and at a minimum of 13 months after the operation.

Risedronate does not enhance fixation or BMD in revision cups: randomised study with three years follow-up.

Background: Bisphosphonates may improve implant fixation by inhibition of bone resorption and stimulation of osteoblasts by up regulation of BMP-2. However, there are few clinical studies in this area.

Questions/purpose: Does treatment with oral bisphosphonates improve implant fixation and bone remodelling around the acetabular component after revision arthroplasty with or without use of morselised allograft?

Patients And Methods: Fifty-three patients received university pharmacy blinded medication for three months: 5 mg risedronate or placebo one dosage and 1 g calcium carbonate and 800IE cholecalciferol per day.

Simultaneous measurements of knee motion using an optical tracking system and radiostereometric analysis (RSA).

Background And Purpose: Invasive methods are more reproducible and accurate than non-invasive ones when it comes to recording knee kinematics, but they are usually less accessible and less safe, mainly due to risk of infection. For this reason, non-invasive methods with passive markers are widely used. With these methods, varying marker sets based on a number of single markers, or sets of markers, known as clusters, are used to track body segments.

Comparison of cementing techniques of the tibial component in total knee replacement.

A few studies have shown that cementing the stem enhances fixation of the tibial baseplate in total knee replacement (TKR). Even the horizontal technique has been shown to provide good fixation. We used radiostereometry to study migration of the tibial component in 30 knees operated with Profix TKR.

Joint area constraint had no influence on bone loss in proximal tibia 5 years after total knee replacement.

After total knee replacement (TKR) the bone mineral density (BMD) decreases in the proximal tibia. Our aim was to evaluate if changes in constraint of the cemented AMK TKR (DePuy, Johnson & Johnson, Leeds, UK) had any effect on postoperative bone remodeling in the proximal tibia. We used dual-energy X-ray absorptiometry in 43-53 knees to record changes in BMD in three regions of interest around the tibial component up to 5 years after operation with the AMK (DePuy) TKR.

Abnormal motion of the medial femoral condyle in lateral knee osteoarthritis.

The pattern of knee motion in patients with lateral osteoarthritis may be associated with the pathogenesis of this disease. Based on previous findings of decreased anteroposterior femoral condylar translation in knees with medial knee osteoarthritis, we asked whether a similar pattern of knee kinematics in lateral osteoarthritis could be related to the wear pattern on the tibial plateau. We used sequential radiostereometric images to study kinematics during active weightbearing extension in five knees with lateral osteoarthritis and 11 control knees.

Influence of polyethylene constraint on tibial component fixation in total knee arthroplasty: follow-up report after 5 years.

The influence of articulating surface design of AMK total knee prosthesis (DePuy, Johnson & Johnson) on migration and radiographic outcome at 5 years was evaluated. The knees were randomly allocated to receive a flat or a concave insert with retention of the posterior cruciate ligament when preoperative deformity was less severe and either a concave or a posterior-stabilized insert with resection of the posterior cruciate ligament when deformity was more pronounced. In 64 knees, migration was measured with radiostereometry.

Hip and knee joint rotations differ between patients with medial and lateral knee osteoarthritis: gait analysis of 30 patients and 15 controls.

The motions and moments in the hip and knee in female patients on the waiting list for knee prosthesis surgery with medial (n = 15) or lateral (n = 15) osteoarthritis (OA) were compared with a control group (n = 15). We hypothesized that not only the kinematics and kinetics of the knee but also of the hip would differ between patients the medial and lateral groups. At midstance, patients with lateral OA showed slightly (2 degrees) more maximal (peak) adduction (p = 0.

Changed gait pattern in patients with total knee arthroplasty but minimal influence of tibial insert design: gait analysis during level walking in 39 TKR patients and 18 healthy controls.

Introduction: Previous radiostereometric studies have revealed abnormal anterior-posterior translation of the femur in patients operated with AMK (DePuy, Johnson and Johnson, Leeds, UK) total knee arthroplasty (TKA). Based on these observations, we hypothesized that patients with TKA have an abnormal gait pattern, and that there are differences in kinematics depending on the design of the tibial joint area.

Method: We used a gait analysis system to evaluate the influence of joint area design on the kinematics of the hip and knee during level walking.

Knee kinematics in medial arthrosis. Dynamic radiostereometry during active extension and weight-bearing.

We studied the kinematics of the knee during weight-bearing active extension in 14 patients with medial osteoarthrosis (OA) and in 10 controls using dynamic radiostereometry. Between 50 degrees and 20 degrees of extension the OA knees showed decreased internal tibial rotation corresponding to less posterior displacement of the lateral femoral flexion facet center. The midpoint between the two tips of the tibial intercondylar eminence occupied a more posterior position within the range of motion analyzed.

The effect of tibial insert design on rising from a chair; motion analysis after total knee replacement.

Background: There are few previous studies of sit-to-stand movement following total knee arthroplasty. Aim of the study was to test the hypotheses that total knee replacement alters the maximum trunk, hip, knee and ankle flexion-extension movements during chair rising, and that the design of the tibial plateau has small influence on the kinematics.

Methods: A motion analysis system was used to evaluate kinematics of the trunk, hip, knee and ankle when rising from one chair and sitting down on another.

Total knee replacement influences both knee and hip joint kinematics during stair climbing.

A gait analysis system was used to evaluate the kinematics of the hip and knee during stair ascending and descending after operation with total knee replacement. Patients with 5 degrees varus/valgus alignment or less were selected randomly to receive either a flat or a concave tibial component with retention of the posterior cruciate ligament. Patients who had more than 5 degrees varus/valgus alignment and/or an extension defect of 10 degrees or more were selected randomly to receive the concave or posterior-stabilized tibial component with resection of the posterior cruciate ligament.

Kinematics of three variations of the Freeman-Samuelson total knee prosthesis.

The effect of changes in the articulating surfaces on the kinematics of the Freeman-Samuelson total knee replacement was evaluated. Twenty-two patients (22 knees) (median age, 69 years) were randomized to a standard design with a fixed polyethylene bearing, a design with a mobile bearing, or a new design with a spherical medial femoral condyle with a fixed bearing. The patients were studied with radiostereometry and film-exchangers at 0 degrees nonweightbearing and during active weightbearing extension from 45 degrees to 15 degrees.