Gender-related morphological differences in sulcus angle and condylar height for the femoral trochlea using magnetic resonance imaging

Koh, Yong‐Gon; Nam, Ji-Hoon; Chung, Hyun Seok; Lee, Hwa Yong; Kim, Ho-Joong; Kim, Hyo Jeoung; Kang, Kyoung‐Tak

doi:10.1007/s00167-019-05423-4

Cited by 25 publications

(30 citation statements)

References 38 publications

(74 reference statements)

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“…6). Recently, a three-dimensional morphology study showed a gender difference for femoral posterior condylar offset and condylar height for the femoral trochlea in the Korean population (Koh et al, 2019b;Koh et al, 2019c). This study provides guidelines for the design of a suitable femoral component for TKA considering gender-specific differences in the Korean population (Koh, Nam, Chung, Kim, Chun and Kang, 2019b;Koh, Nam, Chung, Lee, Kim, Kim and Kang, 2019c).…”

Section: Fig 5 Schematic Of a Subject-specific Musculoskeletal Modelmentioning

confidence: 75%

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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Section: Fig 5 Schematic Of a Subject-specific Musculoskeletal Modelmentioning

confidence: 75%

Computational biomechanics of knee joint arthroplasty : a review

Kang

Koh

Lee

et al. 2020

Mechanical Engineering Reviews

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“…The TEA projection technique was applied on the tibia as described by Akagi et al 7 and Bonnin et al 22 . The use of 3-D reconstructions in radiology for descriptive anatomical studies or examination of pathologic lesions is well guided in previous studies 7, [22][23][24] . Using these techniques, the number of available subjects is larger, and their demographic data are accessible.…”

Section: Discussionmentioning

confidence: 99%

“…First, MRI scans were used to develop the 3D representations of the femur and tibia in this study, and there could be some errors in the computation model. Nevertheless, the reconstruction soft tissues such as the articular cartilage needs to be performed on MRI, and potential inaccuracies in 3D reconstructions could be reduced using protocols used in our previous studies 23 , 24 . Second, our population lacks ethnic diversity, and the results might differ in other populations.…”

Section: Discussionmentioning

confidence: 99%

“…The MRI scans were imported into the software Mimics version 17.0 (Materialise, Leuven, Belgium) and segmented to develop 3D bony and cartilage models of the femur and tibia. A 3D reconstruction reproducibility analysis was performed using a method similar to previous studies 23,24 . On the femur, the TEA was defined using the lateral and medial condyles.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging

Nam

Koh

Kim³

et al. 2020

Sci Rep

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Surgeon-dependent factors such as optimal implant alignment of the tibial component are thought to play a significant role in the outcome following primary total knee arthroplasty (TKA). In addition, tibial component malrotation is associated with pain, stiffness, and altered patellofemoral kinematics in TKA. However, measuring tibial component rotation after TKA is difficult. Therefore, the purpose of this study was to find a reliable method for positioning the tibial component in TKA. To investigate the morphology of the tibial plateau, 977 patients' knees (829 females and 148 males) were evaluated using MRI. The relationships between the femoral transepicondylar axis (TEA), Akagi line, posterior tibial margin (PTM), medial third of the tibial tubercle (MTT), and anatomical tibial axis (ATS) were investigated in this study. In addition, gender difference in tibial rotational alignment were evaluated. Relative to the TEA, the MTT and ATS were externally rotated by 0.5° ± 4.4° and 0.5° ± 5.4°, respectively, while Akagi line and PTM were internally rotated by 3.7° ± 4.5° and 9.9° ± 6.1°, respectively. Gender differences were found in MTT, Akagi line and ATS (P < 0.05). Our result showed that the rotational alignment led to notable variance between femoral and tibial components using fixed bone landmarks. The MTT and ATS axes showed the closest perpendicular aspect with projected TEA. And the MTT and Akagi axes showed the reduced variance. In addition, PTM is not a reliable landmark for rotation of the tibial component. Based on the results of this study, surgeons may choose the proper anteroposterior axis of the tibial component in order to reduce rotational mismatch and improve clinical outcomes.

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“…The sulcus angle and Insall-Salvati ratio were confirmed to be within normal limits for all knees. 12,24 None of the specimens showed signs of advanced degeneration during inspection using knee arthroscopy. Specimens consisted of 25 cm of the femur and tibia.…”

Section: Specimen Preparationmentioning

confidence: 96%

Posterior Tibial Loading Results in Significant Increase of Peak Contact Pressure in the Patellofemoral Joint During Anterior Cruciate Ligament Reconstruction: A Cadaveric Study

et al. 2021

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Background: Inappropriate posterior tibial loading and initial graft tension during anterior cruciate ligament (ACL) reconstruction may cause altered patellofemoral joint (PFJ) contact mechanics, potentially resulting in pain and joint degeneration. Hypothesis: PFJ contact pressure would increase with the increases in posterior tibial loading and graft tension during ACL reconstruction. Study Design: Controlled laboratory study. Methods: Nine fresh-frozen, nonpaired human cadaveric knees were tested in a customized jig from 0° to 120° of knee flexion. First, the knee was tested in the ACL-intact state. Second, reconstruction of the ACLs using different posterior tibial loadings and graft tensions were performed. The posterior tibial loading was evaluated at 2 levels: 33.5 and 67 N. Graft tension was assessed at 3 levels: low tension (20 N), medium tension (60 N), and high tension (80 N). Maximum values of peak contact pressure in the medial and lateral patellar facets were compared between ACL-intact and ACL-reconstructed knees. The PFJ kinematics between ACL-intact knees and ACL-reconstructed knees were compared during knee flexion at 30°, 60°, 90°, and 120°. Results: Reconstruction of ACLs with both low and high posterior tibial loading resulted in significant increases of peak contact pressure in the medial (range of differences, 0.46-0.92 MPa; P < .05) and lateral (range of differences, 0.51-0.83 MPa; P < .05) PFJ compared with the ACL-intact condition. However, no significant differences in PFJ kinematics were identified between ACL-reconstructed knees and ACL-intact knees. In ACL-reconstructed knees, it was found that a high posterior tibial loading resulted in high peak contact pressure on the medial patellar side (range of differences, 0.37-0.46 MPa; P < .05). No significant difference in peak contact pressure was observed among the differing graft tensions. Conclusion: In this cadaveric model, ACL reconstruction resulted in significant increases of peak contact pressure in the PFJ facet when compared with the ACL-intact condition. A high posterior tibial loading can lead to high medial PFJ peak contact pressure. Graft tension was found to not significantly affect PFJ contact pressure during ACL reconstruction. Clinical Relevance: An excessive posterior tibial loading during ACL reconstruction resulted in increased PFJ contact pressures at time of surgery. These data suggest that a low posterior tibial loading might be preferred during ACL reconstruction surgery to reduce the PFJ contact pressure close to that of the ACL-intact condition.

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Gender-related morphological differences in sulcus angle and condylar height for the femoral trochlea using magnetic resonance imaging

Cited by 25 publications

References 38 publications

Computational biomechanics of knee joint arthroplasty : a review

Computational biomechanics of knee joint arthroplasty : a review

Evaluation of tibial rotational axis in total knee arthroplasty using magnetic resonance imaging

Posterior Tibial Loading Results in Significant Increase of Peak Contact Pressure in the Patellofemoral Joint During Anterior Cruciate Ligament Reconstruction: A Cadaveric Study

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