Over-voluming predicted by pre-operative planning in 24% of total knee arthroplasty

Marmor, Simon; Renault, E.; Valluy, Jeremy; Saffarini, Mo

doi:10.1007/s00167-018-4998-z

Cited by 16 publications

(12 citation statements)

References 30 publications

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“…Therefore, existing ready-made distal femoral prostheses can hardly cover the bone surface after cutting. Postoperative residual pain and rigidity are related to protrusion of the prosthesis and excessive size of the femoral components [ 5 ]. Implants not matching the bone surface after cutting may lead to ligament balance, patellar dislocation, and soft tissue impingement [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that bone-implant mismatch can occur in TKA due to variation in the aspect ratio (ML/AP; ML = medial-lateral width, AP = anteroposterior length) and the asymmetry ratio (LAP/MAP; LAP = lateral anteroposterior, MAP = medial anteroposterior) [ 4 ]. Marmor et al reported that over-voluming occurred in 24% of TKA pre-operative planning [ 5 ]. In the past decade, studies on distal femur morphology have primarily focused on the aspect ratio of the distal femur [ 6 , 7 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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The Morphology of a Kinematically Aligned Distal Femoral Osteotomy Is Different from That Obtained with Mechanical Alignment and Could Have Implications for the Design of Total Knee Arthroplasty

Shen

Baik

Won

2022

JPM

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Background: Kinematically aligned total knee arthroplasty (KA-TKA) may lead to a different pattern of osteotomy from mechanically aligned total knee arthroplasty (MA-TKA). This paper aims to analyze the effects of KA and MA on the morphology of the distal femoral osteotomy surface. Methods: Computed tomography scans of 80 TKA candidates were reconstructed into 3D models. The measurement of bone morphology was performed after the distal femur cut according to two different alignment techniques. The aspect ratio, trapezoidicity ratio, and asymmetry ratio of the distal femur were assessed. Results: The aspect ratio and the asymmetry ratio in the KA group was significantly lower than that in the MA group in the general population (p < 0.001). The trapezoidicity ratio in the KA group was significantly higher than that in the MA group in the general population (p < 0.001). Conclusions: It was found that KA-TKA and MA-TKA presented different morphologies of the distal femoral osteotomy surface, and this difference was also influenced by gender. The surgery pattern of KA-TKA and MA-TKA and gender should be considered when surgeons choose femoral prostheses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Morphology of a Kinematically Aligned Distal Femoral Osteotomy Is Different from That Obtained with Mechanical Alignment and Could Have Implications for the Design of Total Knee Arthroplasty

Shen

Baik

Won

2022

JPM

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“…Excessive deformity correction may also lead to oversizing, particularly if under-resections are performed to maintain the joint line. 6,20 Furthermore, despite the production of genre- [21][22][23] or ethnic-specific implants, existing ranges fail to cover the polymorphism observed among populations. [24][25][26] Further development of existing ranges, or the advent of patient-specific implants, may be necessary before prosthetic oversizing or overhang can be completely eliminated.…”

Section: Discussionmentioning

confidence: 99%

“…Despite successful total knee arthroplasty (TKA), an estimated 20% of patients report dissatisfaction 1 due to unexplained pain and stiffness. [2][3][4] These complications were considered to result from an oversized or overhanging component, 5,6 which can lead to soft tissue impingement 7,8 or patellofemoral overstuffing. 9,10 Soft tissue balancing is an important step in successful TKA, enabling the surgeons to determine the optimal component size.…”

Section: Introductionmentioning

confidence: 99%

Effect of the posterior sagging control device to the posterior tibial translation during posterior-stabilized total knee arthroplasty with modified gap technique

Maeyama

Asayama

Ishimatsu

et al. 2022

J Orthop Surg (Hong Kong)

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Purpose In modern total knee arthroplasty (TKA), flexion and extension gaps between the femur and tibia are equilibrated before implanting the final components. Uncontrolled intraoperative posterior tibial translation (PTT) could cause an artifactual widening of the flexion gap, which could lead surgeons to alter the femoral component size. We designed an intraoperative posterior sagging control device to prevent intraoperative PTT. In this study, we investigated whether the use of this device could prevent artifactual widening of the flexion gap. Methods Twenty-five patients, 21 women and four men, aged 74.2 years, were enrolled in this prospective study. All patients underwent postero-stabilized TKA using a navigation system. Intraoperative PTT, flexion and extension gaps with or without using the posterior sagging control device were measured with navigation system. These measurements were compared with or without the posterior sagging control device and after the final implantation also. Results There were significant differences between the measurements performed with or without the posterior sagging control device when compared to the post-implantation measurements. The use of the device reduced the number of patients with a >3 mm increase in flexion gap from 7 (28%) to 1 (4%). Conclusion This study suggests that the posterior sagging control device prevents PTT and artificial flexion gap widening. This could prevent an unnecessary increase in component size.

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“… 83 The relationship between overstuffing and pain is unclear. A study by Marmor et al 84 showed that overstuffing TKRs is associated with extensive osteophytes and intra-articular femoral valgus which may suggest an association with excessive joint tension due to implant protrusion contributing to knee pain and stiffness. A study by Kemp et al 85 showed that there is no association between Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and combined patellofemoral overstuffing involving the patella and trochlea.…”

Section: Overstuffingmentioning

confidence: 99%

Literature review of the causes of pain following total knee replacement surgery: prosthesis, inflammation and arthrofibrosis

Chung

Ali

et al. 2020

EFORT Open Reviews

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Adverse knee pain occurs in 10–34% of all total knee replacements (TKR), and 20% of TKR patients experience more pain post-operatively than pre-operatively. Knee pain is amongst the top five reasons for knee replacement revision in the United Kingdom. The number of TKRs is predicted to continue increasing due to the ageing population. A narrative literature review was performed on the different causes of pain following TKR. A database search on Scopus, PubMed, and Google Scholar was conducted to look for articles related to TKR, pain, and cause. Articles were selected based on relevance, publication date, quality of research and validation. Relevant sections were added to the review. One hundred and fourteen articles were identified and potential causes of TKR pain included: arthrofibrosis, aseptic loosening, avascular necrosis, central sensitization, component malpositioning, infection, instability, nerve damage, overstuffing, patellar maltracking, polyethylene wear, psychological factors and unresurfaced patella. It is important to tailor our approach to address the individual causes of pain. Certain controllable risk factors can be managed pre-operatively to minimize post-operative pain. Risk factors help to predict adverse pain outcomes and identify specific causes. There are multiple causes of pain following TKR. Some factors will require further extensive studies, and as pain is a commonly attributed reason for TKR revision, its underlying aetiologies should be explored. Understanding these factors helps to develop effective methods for diagnosis, prevention and management of TKR pain, which help to improve patient outcomes. Cite this article: EFORT Open Rev 2020;5:534-543. DOI: 10.1302/2058-5241.5.200031

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Over-voluming predicted by pre-operative planning in 24% of total knee arthroplasty

Abstract: IV, Retrospective cohort study.

Cited by 16 publications

References 30 publications

The Morphology of a Kinematically Aligned Distal Femoral Osteotomy Is Different from That Obtained with Mechanical Alignment and Could Have Implications for the Design of Total Knee Arthroplasty

The Morphology of a Kinematically Aligned Distal Femoral Osteotomy Is Different from That Obtained with Mechanical Alignment and Could Have Implications for the Design of Total Knee Arthroplasty

Effect of the posterior sagging control device to the posterior tibial translation during posterior-stabilized total knee arthroplasty with modified gap technique

Literature review of the causes of pain following total knee replacement surgery: prosthesis, inflammation and arthrofibrosis

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