Knee biomechanics

Clement, Nick D; Deehan, David J.

doi:10.1302/2046-3758.75.bjr-2017-0360

Cited by 5 publications

(4 citation statements)

References 19 publications

(20 reference statements)

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“…It has been well established that coronal malalignment increases the risk of tibiofemoral OA [5]. Varus and valgus alignment shifts the load-bearing axis, respectively, medial and lateral to knee center, creating a moment arm that increases forces across the tibial plateau [1]. The median value of AMA measured in the present study was 5 (2.9; 6.8) that represents the "normal" and physiological alignment of lower limb with a load-bearing axis that runs through center hip, knee and ankle [20].…”

Section: Discussionmentioning

confidence: 99%

“…However, a clear definition of "normal axial and rotational alignment" in non-arthritic adults has not been established yet. Any femur, patella and tibia axial and rotational malalignment might have a direct effect on the load transmitted through the joint leading to increase cartilage wear and degeneration [1]. Knee surgeons learned from total knee arthroplasty (TKA) procedures that a malposition of implants due to axial and/or rotational malalignment can result in higher revision rates and lower patient-reported outcome scores [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Axial and rotational alignment of lower limb in a Caucasian aged non-arthritic cohort

Farinelli

Baldini

Bucci

et al. 2020

Eur J Orthop Surg Traumatol

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Background The alignment of human lower limb has been an area of ongoing study for decades. The purpose of this study was to analyze the axial and rotational alignment from hip to ankle in a Caucasian aged non-arthritic cohort. Methods A non-arthritic cohort of aged patients was retrospectively analyzed by computer tomography. Anatomical-mechanical angle of femur (AMA), femur inclination (FI), femoral anteversion (FA), posterior condylar angle (PCA), proximal tibial torsion (TEAs-PTC and TEAs-PTT) and tibial fibular torsion (PTC-TFA) were measured. Results The median age of the patients was 76 years (range 67 to 91 years). Regarding axial alignment, the AMA was 5 (2.94; 6.80). No significance differences were reported by side and age. AMA was significantly lower in men. The FI was 125.3 (120.0; 134.8) with no differences in terms of side, age or gender. Regarding torsion alignment, the median values of FA, PTC-TFA and TEAs-PTT were, respectively, 16.8, 28.5 and − 1.4. No differences were reported by age. Right tibia was externally rotated by 1.5 degrees as compared to the left side (P 0.035). Conclusion The broad variability of the parameters analyzed highlights the necessity for a more anatomical and individualized approach during surgery of lower limb. The present study offers the fundament to understand and treat lower limb deformities. Hence, these data can constitute the normal reference values useful to investigate lower limb malalignment. Moreover, it helps to assess the possible changes of axial and rotational alignment in idiopathic OA of lower limb. Level of evidence III Retrospective cohort study

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Axial and rotational alignment of lower limb in a Caucasian aged non-arthritic cohort

Farinelli

Baldini

Bucci

et al. 2020

Eur J Orthop Surg Traumatol

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“…Models also provide insight into measures not easily obtained experimentally, such as contact mechanics, interface shear loading, or muscle force requirements during a dynamic activity (Rullkoetter, Fitzpatrick and Clary, 2017). Previous work has shown the role of computational analysis in deciphering the complex interplay between component positioning of the implanted TKA and the kinetics of soft-tissue structures (Clement and Deehan, 2018).…”

Section: Discussionmentioning

confidence: 99%

Computational biomechanics of knee joint arthroplasty : a review

Kang

Koh

Lee

et al. 2020

Mechanical Engineering Reviews

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Computational models have been widely used for more than four decades to evaluate the mechanical behavior of knee joint arthroplasty. Validated computational models provide a virtual platform to develop optimal articular surfaces which achieve desired implant characteristics. This review paper provides a comprehensive overview of the computational models available to represent knee joint arthroplasty. A brief overview of knee joint anatomy and arthroplasty is provided, followed by computational model development techniques. Use of the computational models in development of knee joint arthroplasty and pre-or post-clinical evaluation is summarized. This review paper presents current modeling capabilities for implant design and stability, with further suggestions for studying the performance of implants on a population level. However, simulations must include closely corroborated multi-domain analysis in order to account for real-life variability.

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“…Fast-track to 2019, and we have at our disposal advanced technologies such as computer navigation and robotic-assisted surgery, which allow us to plan and achieve the desired component position, limb alignment and soft tissue balance with increasing accuracy for the tibial and femoral components. 106,107 Yet we still ignore the PFJ to a large extent with key determinants of patellar tracking not included in the operative planning or execution – the patella is not visible on the pre-operative plan (Fig. 3), which precludes an evaluation of the depth of resection and component position, and the final intra-operative preparation to accommodate femoral and tibial component translation is performed manually, as is the rotation of the tibial component and the patellar resection.…”

Section: Generation ‘R’mentioning

confidence: 99%

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

Roussot

Haddad

2019

EFORT Open Reviews

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Total knee arthroplasty (TKA) has evolved into a successful, cost-effective treatment for end-stage knee arthrosis. The patellofemoral articulation in TKA has largely been ignored during its development despite being an important determinant of outcome. New technologies still need further development to incorporate the patella in TKA surgical planning and operative technique. Alternative approaches to alignment in TKA will have a secondary impact on patellofemoral mechanics and possibly future implant designs. Technologies that assist with precise implant positioning may alter our understanding and overall practice of TKA. Cite this article: EFORT Open Rev 2019;4:503-512. DOI: 10.1302/2058-5241.4.180094

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Knee biomechanics

Cited by 5 publications

References 19 publications

Axial and rotational alignment of lower limb in a Caucasian aged non-arthritic cohort

Axial and rotational alignment of lower limb in a Caucasian aged non-arthritic cohort

Computational biomechanics of knee joint arthroplasty : a review

The evolution of patellofemoral prosthetic design in total knee arthroplasty: how far have we come?

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