Evaluation of patellofemoral joint in ADVANCE® Medial-pivot total knee arthroplasty

Abstract

Purpose ADVANCE® Medial Pivot (MP) (Wright Medical) total knee arthroplasty (TKA) was established to replicate normal tibio-femoral knee joint kinematics, however, its influence on the patello-femoral (PF) joint is unclear. The purpose in this study was to assess the PF joint conditions in Advance MP TKA, via radiography and three-dimensional image-matching software. Methods Ten subjects with osteoarthritis were treated with the ADVANCE MP TKA. Pre-operatively and one month after surgery, skyline views at 30, 60, and 90°of flexion were taken, and patella shift and tilt were measured. With 2D-3D registration techniques using software, implant orientations were matched with the pre-operative CT and changes in the anterior part of the femoral prosthesis, condylar twist angle (CTA) for femoral rotation, and tibial rotation were evaluated. The relationships between morphological and rotational changes were evaluated. Results There were significant differences in patella tilt at 60°a nd patella shift at all angles between pre-and post-operation (p<0.05). No correlation was found between morphological changes in the anterior femur with patella tilt and shift. A positive correlation between postoperative CTA and patella shift at 90°was found (p<0.05); however, no correlation was found between rotational alignment of the tibial component and patella tilt and shift. Conclusions ADVANCE MP TKA changed patello-femoral joint kinematics, compared to that found before surgery. The kinematic features were mainly due to the design concepts for tibio-femoral joint motion, indicating the difficulty to reproduce normal patello-femoral joint kinematics after TKA.

Analysis of in-vivo articular cartilage contact surface of the knee during a step-up motion

“…Recently, medial pivoting knee motion has also been adopted in several knee replacement designs that are aimed to reproduce anatomic knee joint motion patterns (Chinzei et al, 2014; Ishida et al, 2012; Morra et al, 2008; Pritchett, 2011; Schmidt et al, 2003; Schmidt et al, 2014). However, our data showed that both the medial and lateral cartilage contacts are a convex femur to a convex tibia contact in sagittal plane.…”

Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty

“…The femoral rotational axis could be defined by the navigation system as the average rotation axis of the transepicondylar axis, and the axis perpendicular to the Whiteside line; we also determined the axis using preoperative three-dimensional planning software (Athena Knee), in which the axis was parallel to the surgical epicondylar axis [22,23]. The tibial rotational axis was defined along the line from the medial border of the tibial tubercle to the middle of the posterior cruciate ligament [24].…”

Patellaposition und Patellofemoralarthrose nach unikompartimentellem Kniegelenkersatz

“…[15]; b MIS-Methode: Verhältnis der Länge der artikulierenden Patellarückfläche zur Länge des Lig. patellae [13]; c Blackburne-Peel-Methode: Verhältnis der Länge der artikulierenden Patellarück-fläche zum Lot zwischen dem kaudalstem Punkt der artikulierenden Patellarückfläche und der Tangente zur Tibiaplateauebene [9]; d Caton-Deschamp-Methode: Verhältnis der Länge der artikulierenden Patellarückfläche zum Abstand zwischen dem kaudalstem Punkt der artikulierenden Patellarückfläche und dem ventralstem Punkt des Tibiaplateaus [10] "patella" "unicompartmental replacement" "unicompartmental arthroplasty" "unicompartmental/ Abb. 1 9 Übersicht der Literaturrecherche zur Identifikation von relevanten Studien te eine negative Korrelation zum post operativen "Knee Society Score" aufwie sen. Niedrige präoperative ISWerte kor relierten negativ mit dem postoperativen "Knee Society Score".…”

“…In einer ähnlichen Studie evaluier ten Chinzei et al [10] die Veränderun gen von Patellaverkippung und laterali sation bei jeweils 30°, 60° und 90° Flexion. Hinsichtlich der Patellaverkippung zeigte sich postoperativ eine signifikante Zunah me nur bei 60° Flexion, während sich die Patellalateralisation bei allen gemessenen Beugestellungen signifikant verbesserte.…”