Background: Component alignment is essential to improve knee function and survival in total knee arthroplasty. However, it is still unclear whether the conformity design of tibiofemoral component can mitigate abnormal knee biomechanics caused by component malrotation. The purpose of this study was to investigate whether the sagittal/coronal conformity design of the tibial component could change the effect of the tibial component malrotation on knee biomechanics in total knee arthroplasty.
Methods: A developed patient-specific musculoskeletal multi-body dynamics model of total knee arthroplasty was used to investigate the effects of the sagittal/coronal conformity of the tibial component on knee contact forces and kinematics caused by tibial component malrotation during the walking gait.
Findings: Medial and lateral contact forces, internal-external rotation, and anterior-posterior translation were significantly affected by tibial component malrotation after total knee arthroplasty during the walking gait. The lower sagittal conformity of the tibial component can mitigate the abnormal internal-external rotation caused by tibial component malrotation in total knee arthroplasty, the higher coronal conformity of the tibial component can mitigate the abnormal medial-lateral translation caused by tibial component malrotation in total knee arthroplasty.
Interpretation: This study highlights the importance of the tibiofemoral conformity designs on knee biomechanics caused by component malrotation in total knee arthroplasty. The optimization of the tibiofemoral conformity designs should be thoroughly considered in the design of new implants and in the planning of surgical procedures.
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http://dx.doi.org/10.1016/j.clinbiomech.2023.105985 | DOI Listing |
J Exp Orthop
January 2025
Department of Orthopaedic Surgery, Faculty of Medicine The University of Tokyo Tokyo Japan.
Purpose: To clarify the influence of biomechanics on post-operative clinical outcomes in bicruciate-retaining total knee arthroplasty (BCR-TKA).
Methods: Severe medial osteoarthritis who underwent BCR-TKA were examined. Each patient was asked to perform a squat (weight-bearing [WB]) and active assisted knee flexion (non-WB [NWB]) under single fluoroscopy surveillance.
Cureus
December 2024
Department of Health Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, JPN.
Purpose The infrapatellar fat pad (IFP) has the lowest pain threshold among all knee joint components and causes anterior knee pain after knee arthroplasty. It has been reported that selective muscle atrophy of the vastus medialis (VM) and fibrosis of the IFP may develop following knee joint surgery. Ultrasound enables visualization of IFP deformation (A1) from within the joint to the proximal area in response to muscle contraction, and this may be helpful in developing preventive and therapeutic strategies for IFP fibrosis.
View Article and Find Full Text PDFJ Arthroplasty
January 2025
Georgetown University School of Medicine, MedStar Georgetown University Hospital, Washington, D.C, USA. Electronic address:
Introduction: As the number of revision total knee arthroplasties (rTKA) continues to rise, there is increasing interest in the use of contemporary rotating hinge prostheses. These devices often incorporate porous cones to fill bone defects and enhance long-term fixation. This study evaluated the clinical and functional outcomes and survivorship in rTKA patients utilizing a rotating hinge prosthesis with flexible titanium (FT) cones, porous tantalum (PT) cones, or no cones.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Mechanical Engineering, Yonsei University, Seoul 03722, Republic of Korea.
: Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) uses preoperative three-dimensional imaging to create cutting blocks tailored to patient anatomy. However, there is debate regarding the additional benefits of PSI in terms of improved alignment or functional outcomes compared to using conventional instruments. Although PSI design has undergone continuous development, the improvements have not been incorporated.
View Article and Find Full Text PDFClin Orthop Relat Res
January 2025
Department of Rehabilitation, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Many patients with a lower limb socket-suspended prothesis experience socket-related problems, such as pain, chronic skin conditions, and mechanical problems, and as a result, health-related quality of life (HRQoL) is often negatively affected. A bone-anchored prosthesis can overcome these problems and improve HRQoL, but these prostheses have potential downsides as well. A valid and reliable tool to assess potential candidates for surgery concerning a favorable risk-benefit ratio between potential complications related to bone-anchored prostheses and improvements in HRQoL is not available yet.
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