The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty

Ali, Adam M.; Newman, Simon P.; Hooper, Paul A.; Davies, Catrin M.; Cobb, Justin P.

doi:10.1302/2046-3758.68.bjr-2017-0067.r1

Cited by 21 publications

(8 citation statements)

References 30 publications

(39 reference statements)

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“…Kim et al [14] reported that among 124 Oxford phase 3 UKAs in 104 patients, 13% cases did not gain an acceptable postoperative mechanical axis. Alignment errors may have adverse effects on the wear rate of the mobile bearing, changes in knee kinematics, and implant loosening or failure [28]. Malpositioning may also increase the risk of bearing dislocation in mobile UKA, which highlights the importance of alignment accuracy [9,10].…”

Section: Discussionmentioning

confidence: 99%

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

et al. 2020

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Background: The mobile Oxford unicompartmental knee arthroplasty (UKA) implant has been widely used with an intramedullary guide for femoral preparation. We modified the femoral guide technique based on the tibial cut first and spacer block technique. This study was performed to determine the radiographic accuracy and early clinical outcomes of the extramedullary method. Methods: We retrospectively evaluated 50 consecutive patients who underwent UKA using the extramedullary technique. An equal number of patients who underwent UKA with the conventional technique were matched as the control group. Clinical outcomes were evaluated in terms of the operating time, blood loss, range of motion, and Hospital for Special Surgery score. Radiographic accuracy was evaluated by the implant position and alignment in the coronal and sagittal planes. Results: The mean follow-up period was 39.76 ± 5.77 months. There were no differences in the postoperative Hospital for Special Surgery score, range of motion, or hip-knee-ankle angle between the two groups. The operating time in the extramedullary group was shorter than that in the conventional group (54.78 ± 7.95 vs. 59.14 ± 10.91 min, respectively; p = 0.025). The drop in hemoglobin after 3 days was only 12.34 ± 4.98 g/L in the extramedullary group which was less than that in the conventional group (p = 0.001). No significant differences were found in the postoperative coronal and sagittal angles between the two groups. Acceptable radiographic accuracy of the implant alignment and position was achieved in 92% of patients in the extramedullary group and 96% of patients in the conventional group. Conclusions: The radiographic and clinical results of the extramedullary technique were comparable with those of the conventional technique with the advantage of no intramedullary interruption, less blood loss, a shorter operating time, and more rapid recovery. As the technique depends on the accurate tibial cut and overall alignment, we do not recommend it to surgeons without high volume experiences. Trial registration: Retrospectively registered

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Section: Discussionmentioning

confidence: 99%

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

et al. 2020

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“…9,11,12 Further to the limited regenerative potential, the mismatch between these crescent-shaped implants and the patient-specific lesion areas is a key issue, as it has been demonstrated that even small changes in implant positioning may affect contact pressure and joint stress. 13 To address the limits of meniscus implantation, and to optimize the restoration of meniscal function and joint integrity over time, implants could be developed with an enhanced biological potential and patient-specific sizing to meet individuals’ joint requirements.…”

Section: Introductionmentioning

confidence: 99%

Patient-specific meniscus prototype based on 3D bioprinting of human cell-laden scaffold

Filardo

Petretta

Cavallo

et al. 2019

Bone & Joint Research

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Objectives Meniscal injuries are often associated with an active lifestyle. The damage of meniscal tissue puts young patients at higher risk of undergoing meniscal surgery and, therefore, at higher risk of osteoarthritis. In this study, we undertook proof-of-concept research to develop a cellularized human meniscus by using 3D bioprinting technology. Methods A 3D model of bioengineered medial meniscus tissue was created, based on MRI scans of a human volunteer. The Digital Imaging and Communications in Medicine (DICOM) data from these MRI scans were processed using dedicated software, in order to obtain an STL model of the structure. The chosen 3D Discovery printing tool was a microvalve-based inkjet printhead. Primary mesenchymal stem cells (MSCs) were isolated from bone marrow and embedded in a collagen-based bio-ink before printing. LIVE/DEAD assay was performed on realized cell-laden constructs carrying MSCs in order to evaluate cell distribution and viability. Results This study involved the realization of a human cell-laden collagen meniscus using 3D bioprinting. The meniscus prototype showed the biological potential of this technology to provide an anatomically shaped, patient-specific construct with viable cells on a biocompatible material. Conclusion This paper reports the preliminary findings of the production of a custom-made, cell-laden, collagen-based human meniscus. The prototype described could act as the starting point for future developments of this collagen-based, tissue-engineered structure, which could aid the optimization of implants designed to replace damaged menisci. Cite this article : G. Filardo, M. Petretta, C. Cavallo, L. Roseti, S. Durante, U. Albisinni, B. Grigolo. Patient-specific meniscus prototype based on 3D bioprinting of human cell-laden scaffold. Bone Joint Res 2019;8:101–106. DOI: 10.1302/2046-3758.82.BJR-2018-0134.R1.

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“…The camera setup has a 1936 × 1261 pixel camera resolution, and with the selected field of view used in this study (75/45/25 mm) a measurement sensitivity of 0.37 microns in plane and 1.11 microns out of plane was achieved. The digital image correlation method has been used in many different areas of biomechanics including bone and tissue strain analysis, 18 , 19 dental applications, 20 , 21 and knee and hip arthroplasty, 22 – 26 as it allows for full field measurements of displacement and strain. The camera system collected full-field displacement data at 10 frames per second at specified intervals during the testing.…”

Section: Methodsmentioning

confidence: 99%

Reverse Total Shoulder Arthroplasty Baseplate Stability in Superior Bone Loss With Augmented Implant

Martin

Duquin

Ehrensberger

2021

Journal of Shoulder and Elbow Arthroplasty

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Background Glenoid bone loss is commonly encountered in cases of rotator cuff tear arthropathy and can create challenges during reverse shoulder arthroplasty. In this study, we sought to investigate the biomechanical properties of a new treatment option for superior glenoid defect, an augmented reverse total shoulder baseplate. Methods Three conditions were examined: non-augmented baseplate without defect, non-augmented baseplate with defect, and augmented baseplate with defect. The augmented baseplates included a 30-degree half wedge which also matched the created superior defect. The samples were cyclically loaded at a 60° simulated abduction angle to mimic baseplate loosening. The migration and micromotion of the baseplate were measured on the superior edge using a 3D Digital Image Correlation System. Results The migration measured in the augmented baseplate showed no significant difference when compared to the no defect or defect cases. In terms of micromotion, the augmented baseplate showed values that were between the micromotions reported for the no defect and defect conditions, but not by a statistically significant amount. Conclusion This study provides biomechanical evidence that augmented baseplates can reduce the amount of micromotion experienced by the RSA construct in the presence of significant superior glenoid bone deficiency, but do not fully restore stability to that of a full contact non-augmented baseplate.

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The effect of implant position on bone strain following lateral unicompartmental knee arthroplasty

Cited by 21 publications

References 30 publications

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

A novel extramedullary technique to guide femoral bone preparation in mobile unicompartmental knee arthroplasty based on tibial cut and overall alignment

Patient-specific meniscus prototype based on 3D bioprinting of human cell-laden scaffold

Reverse Total Shoulder Arthroplasty Baseplate Stability in Superior Bone Loss With Augmented Implant

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