Asian-Specific total knee system: 5-14 year follow-up study

Hosaka, Kunihiro; Saito, Shu; Ishii, Teruhisa; Mori, Sei; Sumino, Takanobu; Tokuhashi, Yasuaki

doi:10.1186/1471-2474-12-251

Cited by 26 publications

(20 citation statements)

References 22 publications

(20 reference statements)

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“…Finally, the contact area and stress force of the post-cam was not directly evaluated in our study. Nevertheless, the current study theoretically supports the previously reported clinical outcomes of the FNK PS-TKA, with a good range of motion and recovery of the postoperative quadriceps and hamstring power [5,6].…”

Section: Discussionsupporting

confidence: 90%

“…1). It constrains the valgus-varus motion within ±2°at 0°and ± 4°at 90°of flexion, and the internal-external rotation within ±6°at 90°of knee flexion [5]. Table 1 compares the features of axial rotation and varus-valgus constraint of FNK, with other PS, CCK, and semi-constrained TKA systems.…”

Section: Prosthesis Designmentioning

confidence: 99%

“…Table 1 compares the features of axial rotation and varus-valgus constraint of FNK, with other PS, CCK, and semi-constrained TKA systems. The data were obtained from a survey of four published papers [1,5,14,17] and four commercial, implant websites [18][19][20][21].…”

Section: Prosthesis Designmentioning

confidence: 99%

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Semi-constrained posterior stabilized total knee arthroplasty reproduces natural deep knee bending kinematics

Sumino

Tomita

Sugamoto

et al. 2020

BMC Musculoskelet Disord

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Background: The Flexible Nichidai Knee Posterior Stabilized (FNK-PS) system was designed to provide relatively high varus-valgus stabilities without the stem extensions to patients with severe knee joint disorders. This is a combination of a large tibial post and high femoral cam adapted to a PS system. The aim of our study was to analyze the in vivo two-dimensional/three-dimensional registration kinematics of the FNK PS-total knee arthroplasty (TKA) system during deep knee bending. Methods: Nineteen knees from 15 total knee arthroplasty (TKA) patients who were able to squat with enough knee flexion were selected. During deep knee bending under weight bearing (WB) and non-weight bearing (NWB) conditions, we quantified range of motion, axial rotation, femoral anteroposterior translation, and post-cam engagement angle. Results: The maximum-flexion was significantly different between the two conditions. The mean axial femoral external rotation was 4.8°and 6.2°under WB and NWB conditions, respectively, at 120°flexion. Anteroposterior translation based on bicondylar posterior roll-back patterns was noted with increasing knee flexion. Both the medial and lateral femoral aspects were significantly more posterior during early to mid-flexion. Initial post-cam engagement occurred significantly earlier during flexion under NWB than under WB conditions. Under WB, the timing of the post-cam engagement correlated with the maximum flexion . Conclusions: The kinematics of the semi-constrained PS system reproducibly exhibited a mild external rotation with smooth posterior roll-back. This was assisted by the engagement of the large tibial post and high femoral cam during the early phase of flexion.

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Section: Discussionsupporting

confidence: 90%

Section: Prosthesis Designmentioning

confidence: 99%

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Semi-constrained posterior stabilized total knee arthroplasty reproduces natural deep knee bending kinematics

Sumino

Tomita

Sugamoto

et al. 2020

BMC Musculoskelet Disord

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“…Although TKA is considered a highly successful procedure, with the ability to relieve pain, enhance quality of life, and improve function in patients with knee arthritis [11], nearly all TKA prostheses were designed based on the anthropomorphic features of male [49], Western, and primarily white patients [6, 21]. …”

Section: Introductionmentioning

confidence: 99%

What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review

Kim

Phillips²,

Bhandari

et al. 2017

Clinical Orthopaedics &Amp; Related Research

115

119

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BackgroundMost TKA prostheses are designed based on the anatomy of white patients. Individual studies have identified key anthropometric differences between the knees of the white population and other major ethnic groups, yet there is limited understanding of what these findings may indicate if analyzed collectively.Question/purposeWhat are the differences in morphologic features of the distal femur and proximal tibia among and within various ethnicities?MethodsA systematic review of the PubMed database and a hand-search of article bibliographies identified 235 potentially eligible English-language studies. Studies were excluded if they did not include morphology results or had insufficient data for analysis, were unrelated to the distal femur or proximal tibia, were conducted in pediatric patients or those undergoing unicondylar knee arthroplasty, or bone surface measurements were obtained for trauma products. This left 30 eligible studies (9050 knees). Study quality was assessed and reported as good, fair, or poor according to the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Morphometric data for the distal femur and proximal tibia were available for four ethnic groups: East Asian (23 studies; 5543 knees), white (11 studies; 3111 knees), Indian (three studies; 283 knees), and black (three studies; 113 knees). Although relatively underrepresented, the knees from the Indian and black studies were maintained for hypothesis-generating purposes and to highlight crucial gaps in the data. The two key dimensions for selecting a suitable implant based on a patient’s unique anatomy—AP length and mediolateral (ML) width—were assessed for the femur and tibia, in addition to aspect ratio, calculated by dividing the ML width by the AP length. Study measurement techniques were compared visually when possible to ensure that each pooled study conducted a similar measurement process. Any significant measurement outliers were reviewed for eligibility to determine if the measurement techniques and landmarks used were comparable to the other studies included.ResultsWhite patients had larger femoral AP measurements than East Asians (62 mm, [95% CI, 57–66 mm] vs 59 mm, [95% CI, 54–63 mm]; mean difference, 3 mm; p < 0.001), a smaller femoral aspect ratio than East Asians (1.20, [95% CI, 1.11–1.29] vs 1.25, [95% CI, 1.16–1.34]; mean difference, 0.05; p = 0.001), and a larger tibial aspect ratio than black patients (1.55, [95% CI, 1.40–1.71] vs 1.49, [95% CI, 1.33–1.64]; mean difference, 0.06; p = 0.005).ConclusionsThis analysis uncovered differences of size (AP height and ML width of the femur and tibia) and shape (tibial and femoral aspect ratios) among knees from white, East Asian, and black populations. Future research is needed to understand the clinical implications of these discrepancies and to provide additional data with underrepresented groups.

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“…In the long run, surgeons speculate a lower occurrence of intra-operative and post-operative fractures too. Multiple authors [20,21,22,23,24] have also shown that the the most common problem in implants is with respect to the length and the modified implant tends to perform better in the Asian population compared to their original counterpart. Hence, this highlights the need to modify the humeral implants too.…”

Section: A Related Workmentioning

confidence: 99%

Preliminary development of Asian-specific statistical humeral implants towards minimally invasive implant positioning

Sim

Wong

et al. 2014

2014 IEEE International Conference on Information and Automation (ICIA)

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Implant positioning is highly depending on the morphological matching between the patient anatomical structure and the implants. This paper is investigating the Asian-specific humeral implant development towards more consistent and accurate implant positioning in minimally invasively ways. Humeral implants are currently readily available and used on patients, however these implants are not compatible to every patient, especially the Asian patients due to the difference in the bone size and structure. Surgeons had to consistently modify the surgery which brought a lot of inconvenience to both the patient and the surgeon. The construction of an Asian atlas based implant has therefore been proposed to eradicate this problem. With an Asian atlas, new implants specifically for Asians could be designed and created. Prelude to the design of the implant, data clustering and extraction of the relevant curvature have to be carried out. In this paper, the progress made up to now regarding the design of the implant based on the Asian atlas will be reviewed.

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Asian-Specific total knee system: 5-14 year follow-up study

Cited by 26 publications

References 22 publications

Semi-constrained posterior stabilized total knee arthroplasty reproduces natural deep knee bending kinematics

Semi-constrained posterior stabilized total knee arthroplasty reproduces natural deep knee bending kinematics

What Differences in Morphologic Features of the Knee Exist Among Patients of Various Races? A Systematic Review

Preliminary development of Asian-specific statistical humeral implants towards minimally invasive implant positioning

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