Intraoperative flexion against gravity as an indication of ultimate range of motion in individual cases after total knee arthroplasty

Lee, D.C.; Kim, D.H.; Scott, Richard D.; Suthers, Kathleen

doi:10.1016/s0883-5403(98)90047-x

Cited by 62 publications

(33 citation statements)

References 13 publications

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“…[35][36][37][38][39] In Eastern and Middle Eastern countries, however, a greater degree of flexion is desired for activities such as squatting, kneeling, and sitting cross-legged that are important components of daily living. In Western populations, activities such as kneeling and gardening are also desirable but cannot always be achieved after TKA because of restricted knee flexion.…”

Section: Discussionmentioning

confidence: 99%

In vivo contact stresses during activities of daily living after knee arthroplasty

D’Lima

Steklov

Fregly

et al. 2008

Journal Orthopaedic Research

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ABSTRACT:We implanted an electronic knee prosthesis to measure tibial forces in vivo during activities of daily living after total knee arthroplasty. We used tibial forces and knee kinematic data collected in vivo to calculate contact stresses using finite element analysis. The polyethylene insert was modeled as an elastoplastic material, and predicted contact stresses were validated using pressure sensitive sensors. Peak contact stresses generated during walking were similar but about 18% lower than those calculated for International Standards Organization (ISO)-recommended wear simulation conditions. Stair climbing generated higher contact stresses (32 MPa) than walking (26 MPa). However, both high flexion activities (lunge and kneel) generated even higher contact stresses, with the lunge activity generating the highest stresses (56 MPa). The activities that generated high contact stresses also resulted in high equivalent plastic strain. However, the lunge activity generated dramatically higher plastic equivalent strain than the other activities. In vivo measurement of kinematics, forces, and contact stresses may be used to develop more clinically relevant wear simulator protocols. Contact stresses generated during high flexion activities were substantially higher and were largely due to the reduced contact area in deep flexion rather than due to an increase in contact forces. Our results support the use of ''high flexion'' designs that improve contact conditions and preserve contact area at high flexion angles. ß

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Section: Discussionmentioning

confidence: 99%

In vivo contact stresses during activities of daily living after knee arthroplasty

D’Lima

Steklov

Fregly

et al. 2008

Journal Orthopaedic Research

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“…Post-operative stiffness, which is attributed to arthrofibrosis which occurs in the knee joint, can be extremely debilitating for the patient, often making activities of daily living such as climbing stairs or rising from a chair painful and difficult [3,4]. The causes of arthrofibrosis after total knee arthroplasty surgery are multifactorial.…”

Section: Contents Lists Available At Sciverse Sciencedirectmentioning

confidence: 99%

Management of stiffness following total knee arthroplasty: A systematic review

Abdel-Ghani

Maffulli²,

Khanduja

2012

The Knee

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“…Among these studies, only 4 used a questionnaire that evaluates specifically the physical function of the lower limbs (15,19,20,27). In other studies, the variables predicted were not directly related to functional ability (e.g., length of stay, discharge destination, occurrence of complications, or surgical failure) (18,29 -36) or long-term postoperative outcomes were predicted using postoperative variables measured earlier in the recovery period (37)(38)(39). Thus, there is still a need to identify the preoperative predictors of quantitatively measured locomotor ability during the early stage after TKA.…”

Section: Introductionmentioning

confidence: 99%

Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

Parent

Moffet

2003

Arthritis & Rheumatism

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Objective. To identify preoperative predictors of locomotor ability 2 months after total knee arthroplasty (TKA). Methods. Sixty-five participants scheduled for a first TKA were recruited. The dependent variable was the distance covered during the 6-minute gait test 2 months after TKA. The independent variables, measured before surgery, were grouped into 3 categories: 1) personal; 2) organic system, and 3) capability variables. Multiple regression analyses were conducted to determine the best predictors of the dependent variable. Modified cross-validation of the model combining predictors from the three categories was obtained with 10 random samples derived from the original cohort by resampling with replacement. Results. Predictors were identified in the 3 categories: 1) gender, number of comorbidities, body mass index, 2) knee pain, flexion and strength, lower limb mechanical power, and 3) preoperative 6-minute gait distance. When these variables were modeled together only the preoperative 6-minute gait distance and knee pain and flexion remained significant (adjusted R 2 ‫؍‬ 0.66). Conclusion. Using variables easily measured before surgery, it is possible to predict with good accuracy locomotor ability 2 months after TKA.

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Intraoperative flexion against gravity as an indication of ultimate range of motion in individual cases after total knee arthroplasty

Cited by 62 publications

References 13 publications

In vivo contact stresses during activities of daily living after knee arthroplasty

In vivo contact stresses during activities of daily living after knee arthroplasty

Management of stiffness following total knee arthroplasty: A systematic review

Preoperative predictors of locomotor ability two months after total knee arthroplasty for severe osteoarthritis

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