Biomechanical Considerations in Total Knee Replacement

Allen, Matthew J.; Mann, Kenneth A.

doi:10.1002/9781118704776.ch9

Cited by 2 publications

(2 citation statements)

References 47 publications

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“…22 Loss of fixation in constrained implants has been hypothesized to be due to the high stress transmitted through the hinged joint, and increased load transfer across the implant-cement-bone interface. 23 A proximal hydroxyapatite-coated collar for osteointegration, to augment the long-term implant-bone stability, was therefore manufactured on the endoprosthesis used in both cases, as this has been shown to reduce the risk of aseptic loosening in humans. [24][25][26] Avoiding micromotion is, however, imperative to achieve osseointegration of implants, requiring rigid fixation and adequate bone-implant contact to provide long-term stability.…”

Section: Discussionmentioning

confidence: 99%

Limb-Sparing Surgery in Two Cats Using a Femoral Endoprosthesis with an Integrated Total Knee Replacement Implant

Kvale

Rueda²,

Fitzpatrick³

2022

Vet Comp Orthop Traumatol

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Objective The aim of this study was to describe a novel limb-sparing technique for the management of feline bone neoplasia using a custom-made femoral endoprosthesis in combination with a total knee replacement (TKR) prosthesis. Methods Two cats with distal femoral bone tumours underwent pelvic limb salvage procedures with custom-made implants designed from patient-specific computed tomography images to replace the distal femur and the stifle. In case 1, the first-generation implant was a combination of a cemented femoral endoprosthesis with a uniaxial hinged cemented TKR prosthesis. Due to aseptic loosening of the endoprosthesis, revision was performed with a second-generation femoral endoprosthesis modified with a short intramedullary peg and a lateral bone plate for immediate stability. In case 2, a third-generation endoprosthesis with an intramedullary peg and two orthogonal bone plates for immediate stability, combined with a custom-designed rotationally hinged cemented TKR prosthesis, was used. Clinical and radiographic follow-up was recorded. Results After revision surgery in case 1 and with the third-generation implant in case 2, no complications were encountered. Both cats showed minor mechanical restriction of stifle range of motion and good clinical long-term outcome without local tumour recurrence. Clinical Significance The combination of a femoral endoprosthesis and a TKR prosthesis can be a viable alternative for distal femoral limb salvage in cats.

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Section: Discussionmentioning

confidence: 99%

Limb-Sparing Surgery in Two Cats Using a Femoral Endoprosthesis with an Integrated Total Knee Replacement Implant

Kvale

Rueda²,

Fitzpatrick³

2022

Vet Comp Orthop Traumatol

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“…A mechanical axis of a long bone is defined to be drawn between the centers of the proximal and the distal joints (Allen and Mann, 2013;Brinker and O'Conner, 2010;Dismukes et al, 2007;Paley, 2002;Tomlinson et al, 2007;Wood et al, 2014). In human, the center of the knee joint is demonstrated approximately the same using a point at the center of the tibial spines or the midpoint of the tibial plateaus (Moreland et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

Effect of tibial plateau leveling osteotomy on mechanical tibial axis shift in dogs: two dimensional bone study in sagittal plane

Sabanci¹,

Kilimci

ORMAN

2022

Animal Health Production and Hygiene

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To determine the tibial axis shift (TAS), change in tibial plateau angle (TPA), and the position of the tibial articular surface after tibial plateau leveling osteotomy (TPLO) simulation in the tibiae of dogs, tibias of 91 dogs from 23 different breeds were used. The TPA, tibial length, midshaft width, medial tibial condyle length, and distances between the tibial axis (TA) and cranial-most point of the medial condyle were measured on the tibial images. After simulated TPLO, all measurements were retaken. Paired t-tests were used to compare pre- and postoperative variables. Pearson correlation analysis was conducted to assess whether the difference between pre- and postoperative TAS was related to tibial length, tibial width, medial condyle length, and/or the degree of TPA rotation. The results showed that TPLO shifted the cranial-most point of the medial condyle caudally and distally, and the caudal-most point caudally and proximally. These shifts resulted in significant differences between pre- and postoperative distances between the TA and the cranial-most point and its percentage to the medial condyle length. It is concluded that the TPLO led to caudal TAS and altered the position of the articular surface of the medial condyle with respect to the distal part of the tibia.

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Biomechanical Considerations in Total Knee Replacement

Cited by 2 publications

References 47 publications

Limb-Sparing Surgery in Two Cats Using a Femoral Endoprosthesis with an Integrated Total Knee Replacement Implant

Limb-Sparing Surgery in Two Cats Using a Femoral Endoprosthesis with an Integrated Total Knee Replacement Implant

Effect of tibial plateau leveling osteotomy on mechanical tibial axis shift in dogs: two dimensional bone study in sagittal plane

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