Influence of prosthetic joint line position on knee kinematics and patellar position

Yoshii, Ichiro; Whiteside, Leo A.; White, Stephen E.; Milliano, Michael T.

doi:10.1016/s0883-5403(11)80013-6

Cited by 104 publications

(52 citation statements)

References 12 publications

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“…Patellofemoral or anterior knee pain represents one of the most common problems during rehabilitation after total knee arthroplasty (TKA), with postoperative problems reported in 0,5–12% of patients [1-6]. Although the components of the prosthesis may have been implanted correctly, with postoperative radiographs showing no malalignment, patients were often unable to flex the knee or bear weight on the treated joint [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Although the components of the prosthesis may have been implanted correctly, with postoperative radiographs showing no malalignment, patients were often unable to flex the knee or bear weight on the treated joint [5,6]. While many authors observed a theoretical advantage of primary resurfacing of the backside of the patella during TKA in avoiding these problems [1-4,7], others disagreed, and do not recommend routine resurfacing of the patella [8-10].…”

Section: Introductionmentioning

confidence: 99%

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Dynamic in vitro measurement of patellar movement after total knee arthroplasty: an in vitro study

Ostermeier

Buhrmester

Hurschler

et al. 2005

BMC Musculoskelet Disord

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dynamic in vitro measurement of patellar movement after total knee arthroplasty: an in vitro study

Ostermeier

Buhrmester

Hurschler

et al. 2005

BMC Musculoskelet Disord

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“…Coronal plane outliers have been shown to have inferior functional outcomes, earlier loosening, and polyethylene wear [3,22,32,34,42]. Internal rotation of the femoral component has been associated with pain, stiffness, and instability [1,2,8,24,31,44]. In contrast, excessive external rotation of the femoral component leads to symptomatic flexion instability [29], increased shear forces on the patella [25], and medial compartment overload in flexion [15].…”

mentioning

confidence: 99%

Patient-specific Guides Do Not Improve Accuracy in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

Victor

Dujardin

Vandenneucker

et al. 2014

Clinical Orthopaedics &Amp; Related Research

158

197

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Background Recently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial. Questions/purposes We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG. Methods In this randomized controlled trial, we enrolled 128 patients. In the PSG cohort, surgical navigation was used as an intraoperative control. When the suggested cut deviated more than 3°from target, the use of PSG was abandoned and marked as an outlier. When cranial-caudal position or size was adapted, the PSG was marked as modified. All patients underwent long-leg standing radiography and CT scan. Deviation of more than 3°from the target in any plane was defined as an outlier. Results The PSG and conventional cohorts showed similar numbers of outliers in overall coronal alignment (25% versus 28%; p = 0.69), femoral coronal alignment (7% versus 14%) (p = 0.24), and femoral axial alignment (23% versus 17%; p = 0.50). There were more outliers in tibial coronal (15% versus 3%; p = 0.03) and sagittal 21% versus 3%; p = 0.002) alignment in the PSG group than in the conventional group. PSGs were abandoned in 14 patients (22%) and modified in 18 (28%). Conclusions PSGs do not improve accuracy in TKA and, in our experience, were somewhat impractical in that the procedure needed to be either modified or abandoned with some frequency. Level of Evidence Level I, therapeutic study. See instructions for authors for a complete description of levels of evidence.

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“…50 It should be recognised that using different prosthetic designs and elevating the joint line can make the patellar tendon appear relatively short. 51,52 Brilhault and Ries 53 studied patellar height after TKR using three different implant designs, and concluded that the relative shortening of the patellar tendon commonly seen during flexion in bicruciate-substituting TKRs was similar to that of the native knee joint, as in this prosthetic design posterior rollback and external rotation occur simultaneously. This was witnessed to a lesser extent in posterior cruciate-substituting TKRs because the cam and post mechanism allows rollback but not rotation, but it cannot happen in cruciateretaining TKRs, where paradoxical rollback occurs.…”

Section: Patellar Assessmentmentioning

confidence: 96%

The radiological assessment of total and unicompartmental knee replacements

Sarmah

Patel

Hossain

et al. 2012

The Journal of Bone and Joint Surgery. British volume

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Radiological assessment of total and unicompartmental knee replacement remains an essential part of routine care and follow-up. Appreciation of the various measurements that can be identified radiologically is important. It is likely that routine plain radiographs will continue to be used, although there has been a trend towards using newer technologies such as CT, especially in a failing knee, where it provides more detailed information, albeit with a higher radiation exposure. The purpose of this paper is to outline the radiological parameters used to evaluate knee replacements, describe how these are measured or classified, and review the current literature to determine their efficacy where possible.

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Influence of prosthetic joint line position on knee kinematics and patellar position

Cited by 104 publications

References 12 publications

Dynamic in vitro measurement of patellar movement after total knee arthroplasty: an in vitro study

Dynamic in vitro measurement of patellar movement after total knee arthroplasty: an in vitro study

Patient-specific Guides Do Not Improve Accuracy in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

The radiological assessment of total and unicompartmental knee replacements

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