Effects of femoral component placement on the balancing of a total knee at surgery

Zapata, Gabriela; Sanz-Pena, Inigo; Verstraete, Matthias; Walker, Peter S.

doi:10.1016/j.jbiomech.2019.01.056

Cited by 13 publications

(4 citation statements)

References 26 publications

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“…When the knee is tight medially in both flexion and extension and limb alignment is neutral or valgus, then a varus tibial recut is performed as MCL pie-crusting could result in resultant valgus alignment. Whereas this study did not differentiate between releasing the anterior versus posterior bands of the medial collateral ligament during data collection, it is important in the surgical technique to realize that the former primarily affect the flexion balance whereas the latter affect the extension balance [18,19]. Caution must thus be taken to not overly release the anterior structures of the MCL in a knee that is medially tight in extension, thereby avoiding the loosening of the flexion space.…”

Section: Discussionmentioning

confidence: 92%

How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment

Moore

Conditt

Verstraete

2021

Sensors

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To achieve a balanced total knee, various surgical corrections can be performed, while intra-operative sensors and surgical navigation provide quantitative, patient-specific feedback. To understand the impact of these corrections, this paper evaluates the quantitative impact of both soft tissue releases and bone recuts on knee balance and overall limb alignment. This was achieved by statistically analyzing the alignment and load readings before and after each surgical correction performed on 479 consecutive primary total knees. An average of three surgical corrections were required following the initial bone cuts to achieve a well aligned, balanced total knee. Various surgical corrections, such as an arcuate release or increasing the tibial polyethylene insert thickness, significantly affected the maximum terminal extension. The coronal alignment was significantly impacted by pie-crusting the MCL, adding varus to the tibia, or releasing the arcuate ligament or popliteus tendon. Each surgical correction also had a specific impact on the intra-articular loads in flexion and/or extension. A surgical algorithm is presented that helps achieve a well-balanced knee while maintaining the sagittal and coronal alignment within the desired boundaries. This analysis additionally indicated the significant effect that soft tissue adjustments can have on the limb alignment in both anatomical planes.

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Section: Discussionmentioning

confidence: 92%

How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment

Moore

Conditt

Verstraete

2021

Sensors

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“…Anatomically speaking, it can be difficult to precisely position a long-stem revision tibial component because the center of the tibial epiphysis is not colinear with the center of the diaphysis. Similarly, when a long stem of the revision femoral component contacts the sagittal bow of the femur, disruption of gap balance may occur [ 6 , 7 ]. Therefore, implant augmentation and offset couplers were developed to improve bone contact and fine tune implant positioning.…”

Section: Introductionmentioning

confidence: 99%

A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties

MacAskill,

Peluso,

Lash

et al. 2024

Arthroplasty Today

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“…Wearable systems are portable, low costs and can be used without space restrictions [19]. Additionally, they can allow remote monitoring of daily life activities [20] and could be used to evaluate the effects of prosthetic implants location in compartmental and ligament forces [21], [22].…”

Section: Iintroductionmentioning

confidence: 99%

Embedded Pressure Sensing Metamaterials using TPU-Graphene Composites and Additive Manufacturing

Pena¹,

Hopkins²,

Carrero³

et al. 2023

Preprint

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<p>Nearly 15% of the global population is affected by disabilities impacting mobility. Monitoring foot pressure distribution during gait is a fundamental aspect of evaluating rehabilitation. Wearable systems provide a portable alternative to stationary equipment monitoring gait without laboratory space limitations. However, wearable sensors in some applications present challenges in the calibration, sensitivity, and human-sensor interface, requiring application-specific sensors. This study aimed to develop wearable sensors where the structural and material properties can characterise the sensitivity and range of measurement during the design phase. We developed wearable piezoresistive sensors using additive manufacturing to create mechanical metamaterials with embedded pressure-sensing capabilities. The sensors were fabricated in TPU using SLS and graphene ink infusion processes. Three structural designs were developed for different measuring ranges (0 – 50 N, 0 – 100 N, and 0 – 150 N) using body-centred cubic lattices constructed via pyramid unit cells. Two graphene infusion processes were evaluated. We tested the sensors' mechanical and piezoresistive behaviour, measuring the compressive force, strain, and electrical resistance across the sensor. We analysed the influence of structural dimensions and the infusion process on the piezoresistive behaviour. The measuring range was affected mainly by tuneable structural dimensions. The infusion process influenced the piezoresistive sensitivity and affected the linearity response. The results indicate the characterisation of the sensitivity of piezoresistive sensors based on structural parameters and material properties. Mechanical metamaterials could embed pressure sensing in wearables, allowing for customisation based on design parameters using additive manufacture and graphene inks. </p>

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Effects of femoral component placement on the balancing of a total knee at surgery

Cited by 13 publications

References 26 publications

How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment

How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment

A Three-dimensional Comparison of Pre- and Post-component Position in a Series of Off-label Robotic-assisted Revision Total Knee Arthroplasties

Embedded Pressure Sensing Metamaterials using TPU-Graphene Composites and Additive Manufacturing

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