Finite Element Study on the Preservation of Normal Knee Kinematics with Respect to the Prosthetic Design in Patient-Specific Medial Unicompartmental Knee Arthroplasty

Koh, Yong‐Gon; Kang, Kyoung‐Tak

doi:10.1155/2020/1829385

Cited by 8 publications

(3 citation statements)

References 61 publications

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“…In the early 1990s, medial-pivot (MP) TKA was introduced to restore “natural knee kinematics.” The aim was to reproduce the physiologic ball-in-socket mechanism of the medial femoral condyle, while the lateral compartment, being less constrained, allowed an anteroposterior roll of the lateral femoral condyle during knee flexion-extension motion [ 12 , 13 ]. This implant design should avoid the “paradoxical” anterior rolling of the femoral condyles during knee flexion present in various prosthetic models such as the Posterior Stabilized (PS) or the Cruciate Retaining (CR), which reproduce non-physiological knee kinematics [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Giustra

Bosco

Cacciola

et al. 2022

JCM

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In the last decades, several surgical techniques, such as medial pivot (MP) philosophy and kinematic alignment (KA), have been introduced in total knee arthroplasty (TKA) to improve patients’ outcomes. This retrospective study aims to evaluate the clinical, radiographic, and functional results of PCL preservation or sacrifice in KA MP-TKA. A consecutive series of 147 patients older than 60, with a minimum follow-up of two years, were treated with TKA for severe primary knee osteoarthritis (OA) at the Department of Orthopedics and Traumatology between 1 January 2019, and 1 July 2020. After excluding those not meeting the inclusion criteria, 64 patients were included in the study analysis. Regarding radiographic outcomes, no statistically significant difference was observed between patients with preserved or sacrificed PCL (p > 0.05). A slight improvement in Knee Society Score (KSS), knee and function score, and FJS was observed for the PCL-preserved group, although this superiority tendency was not statistically significant (p > 0.05). PCL-preserved MA MP-TKA reported a statistically significant result in only two questions on the FJS questionnaire (p < 0.05). A slight, non-statistically significant improvement in active ROM was found in the PCL-sacrificed group (p > 0.05). No interventions or revisions were reported in this case series for all treated patients at the final follow-up. No significant differences were described in clinical, radiographic, and functional outcomes in preserved or sacrificed PCL KA MP-TKA. Although not significant, a slight trend toward better clinical outcomes was reported in PCL-preserved KA MP-TKA.

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Section: Introductionmentioning

confidence: 99%

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Giustra

Bosco

Cacciola

et al. 2022

JCM

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“…Computational and Mathematical Methods in Medicine lower extremity DVT include underlying patient disease, including the patient's own risk factors for lower extremity vascular disease, diabetic hypertension, dyslipidemia, longterm smoking, and heart valve disease [26]. Therefore, correct preoperative assessment and adequate preoperative preparation are beneficial to predict and prevent the formation of lower extremity deep venous thrombosis.…”

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confidence: 99%

Safety and Efficacy of Unicondylar Knee Prosthesis Treatment for Unicompartmental Osteoarthritis of the Knee Joint

Zhang

2022

Computational and Mathematical Methods in Medicine

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Background. Knee osteoarthritis (KOA) is a chronic disease that seriously endangers the health of the elderly. Choosing appropriate surgery for knee osteoarthritis patients is especially important. Objective. To investigate the safety and efficacy of unicondylar knee prosthesis treatment for unicompartmental osteoarthritis of the knee. Materials and Methods. One hundred patients with unicondylar osteoarthritis of the knee treated in our hospital from June 2019 to June 2021 were selected as retrospective study subjects and were divided into 50 cases each in the comparison group and the observation group according to the different surgical methods. Among them, the comparison group was treated with unicondylar knee arthroplasty (UKA), and the observation group was treated with unicondylar knee prosthesis replacement, and the differences in AKS score, knee flexion angle, tibial angle orthosis, joint mobility, and postoperative recovery were compared between the two groups. Results. The AKS score and knee flexion angle score of the observation group were higher than those of the comparison group after surgery. However, the tibial angle orthopedic score of the observation group was significantly lower than that of the comparison group after surgery for comparison, and the VAS score of the observation group was lower than that of the comparison group. However, the Lysholm score of the observation group was higher than that of the control group after surgery ( P < 0.05 ). The complication rate of patients in the observation group was significantly lower than that of the comparison group, and the HSS score, VAS score, and knee mobility (ROM) of the two groups were statistically significant ( P < 0.05 ) when compared at 7 d after surgery and 6 months after surgery. Conclusion. The clinical efficacy of unicondylar knee prosthesis replacement for osteoarthritis of the knee is better than that of unicondylar knee arthroplasty (UKA) treatment.

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“…These results show the importance of tibiofemoral conformity in preserving the native knee kinematics in patient-specific mobile-bearing UKA [90]. This importance was proved in not only mobile-bearing but also fixed-bearing medial patient-specific UKA [97,98]. The etiology of failure mechanisms is important in the delivery of appropriate care [56].…”

Section: Discussion and Future Directionmentioning

confidence: 74%

Biomechanical and Clinical Effect of Patient-Specific or Customized Knee Implants: A Review

Lee

Koh

Kang

2020

JCM

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(1) Background: Although knee arthroplasty or knee replacement is already an effective clinical treatment, it continues to undergo clinical and biomechanical improvements. For an increasing number of conditions, prosthesis based on an individual patient’s anatomy is a promising treatment. The aims of this review were to evaluate the clinical and biomechanical efficacy of patient-specific knee prosthesis, explore its future direction, and summarize any published comparative studies. (2) Methods: We searched the PubMed, MEDLINE, Embase, and Scopus databases for articles published prior to 1 February 2020, with the keywords “customized knee prosthesis” and “patient-specific knee prosthesis”. We excluded patient-specific instrument techniques. (3) Results: Fifty-seven articles met the inclusion criteria. In general, clinical improvement was greater with a patient-specific knee prosthesis than with a conventional knee prosthesis. In addition, patient-specific prosthesis showed improved biomechanical effect than conventional prosthesis. However, in one study, patient-specific unicompartmental knee arthroplasty showed a relatively high rate of aseptic loosening, particularly femoral component loosening, in the short- to medium-term follow-up. (4) Conclusions: A patient-specific prosthesis provides a more accurate resection and fit of components, yields significant postoperative improvements, and exhibits a high level of patient satisfaction over the short to medium term compared with a conventional prosthesis. However, the tibial insert design of the current patient-specific knee prosthesis does not follow the tibial plateau curvature.

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Finite Element Study on the Preservation of Normal Knee Kinematics with Respect to the Prosthetic Design in Patient-Specific Medial Unicompartmental Knee Arthroplasty

Cited by 8 publications

References 61 publications

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

No Significant Differences in Clinical and Radiographic Outcomes between PCL Retained or Sacrificed Kinematic Aligned Medial Pivot Total Knee Arthroplasty in Varus Knee

Safety and Efficacy of Unicondylar Knee Prosthesis Treatment for Unicompartmental Osteoarthritis of the Knee Joint

Biomechanical and Clinical Effect of Patient-Specific or Customized Knee Implants: A Review

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