Cartilage loss patterns within femorotibial contact regions during deep knee bend

Abstract

Osteoarthritis (OA) can alter knee kinematics and stresses. The relationship between cartilage loss in OA and kinematics is unclear, with existing work focusing on static wear and morphology. In this work, femorotibial cartilage maps were coupled with kinematics to investigate the relationship between kinematics and cartilage loss, allowing for more precise treatment and intervention. Cartilage thickness maps were created from healthy and OA subgroups (varus, valgus, and neutral) and mapped to a statistical bone atlas. Video fluoroscopy determined contact regions from 0° to 120° flexion. Varus and valgus subgroups displayed different wear patterns across the range of flexion, with varus knees showing more loss in early flexion and valgus in deeper flexion. For the femur, varus knees had more wear in the medial compartment than neutral or valgus and most wear at both 0° and 20° flexion. In the lateral femoral compartment, the valgus subgroup showed significantly more wear from 20° to 60° flexion as compared to other angles, though varus knees displayed highest magnitude of wear. For the tibia, most medial wear occurred at 0-40° flexion and most lateral occurred after 60° flexion. Knowing more about cartilage changes in OA knees provides insight as to expected wear or stresses on implanted components after arthroplasty. Combining cartilage loss patterns with kinematics allows for pre-surgical intervention and treatments tailored to the patient׳s alignment and kinematics. Reported wear patterns may also serve as a gauge for post-operative loading to be considered when placing implant components.

Three-dimensional analysis of the tibial resection plane relative to the arthritic tibial plateau in total knee arthroplasty

“…As the body of research improves, quantifying component placement parameters provides important avenues for more appropriate virtual surgical planning and technology-assisted arthroplasty, especially in patients treated with KA TKA. Comparing the results in this work to previously reported cartilage loss patterns in varus osteoarthritic knees (Johnson & Mahfouz 2016 ; Eckstein et al 2010 ), it is reasonable to presume that the correction of varus deformity in the tibia will result in a larger proximal shift in the P-D level of the medial compartment than a lateral shift (3.6 mm ± 1.1 mm medial vs 1.4 mm ± 1.1 lateral) to account for cartilage and bone loss that is predominantly present in the medial compartment. Eckstein has reported that the central medial tibia compartment and external medial tibial compartment are most susceptible to cartilage loss as osteoarthritis progresses-indicating the predominant change in orientation of the tibial plateau will be an increased varus slope and that the F-E orientation may be less affected by pathological changes (Eckstein et al 2010 ).…”

Tibio-Femoral Contact Force Distribution is Not the Only Factor Governing Pivot Location after Total Knee Arthroplasty

“…Within this comparison of kinetics and kinematics, we focused on the squat activity, which is similar to everyday activities like sitting down and rising from a seated position, but provides a consistently high joint loading throughout a large range of knee flexion. Therefore, the squat is regularly used to investigate the loaded kinematics of the knee 26–29 . The aim of this study was to evaluate whether the medio-lateral (ML) pivot location (in the transverse plane) coincides with the ML distribution of the TF contact force.…”

Lateral Unicompartmental Knee Arthroplasty in Structure of Modern Knee Replacement: Is It «Woe From Wit» or a Viable Go-To Method?

“…Наиболее распространенными осложнениями при ОэКС являются асептическое расшатывание, прогрессирование остеоартроза в смежных отделах сустава, вывих подвижного вкладыша, инфекция, нестабильность, необъяснимая боль после эндопротезирования, перипротезный перелом, износ полиэтилена [54,55]. J.A.…”