Patellanavigation bei computerassistierter Knie-TEP-Implantation

Springorum, Hans-Robert; Baier, Christel; Craiovan, Benjamin; Maderbacher, Günther; Renkawitz, Tobias; Grifka, Joachim; Keshmiri, Armin

doi:10.1007/s00132-016-3285-2

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…Alterations of the patella height pre- and postoperatively, as an indicator for any joint line alterations, were determined on lateral views ( Figure 2 ) using the Insall-Salvati ratio and the modified Insall-Salvati ratio [ 18 ]. The lateral patella tilt was measured on skyline views [ 19 , 20 ]. Pre- and postoperative deviation from the ideal mechanical axis was determined using pre- and postoperative AP weight bearing long leg radiographs.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of implant fit and frontal plane alignment after bi-compartmental knee arthroplasty using patient-specific instruments and implants

Arnholdt

Kamawal

Holzapfel

et al. 2018

aoms

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IntroductionThe goals of successful bi-compartmental knee arthroplasty are to achieve correct fit and positioning of the implant, while appropriately correcting the mechanical alignment of the leg after surgery. As these requirements are not always reliably fulfilled using off-the-shelf implant systems, newer approaches for bi-compartmental resurfacing have been explored.Material and methodsIn this article we report the radiographic results of 30 patients with anteromedial osteoarthritis (OA) who were treated with a novel patient-specific fixed-bearing bi-compartmental knee resurfacing system using custom-made implants and instruments. Utilizing standardized pre- and postoperative radiographic analyses (based on anterior-posterior and lateral, anterior-posterior weight-bearing full-length radiographs, patella skyline views and preoperative computed tomography (CT) scanning) implant fit and positioning as well as correction of the mechanical axis (hip-knee-ankle angle, HKA) were determined.ResultsOn average, HKA was corrected from 173.4 ±3.47° preoperatively to 179.4 ±2.85° postoperatively. The coronal femoro-tibial angle was corrected on average 5.61°. The preoperative tibial slope measured on lateral views was 6.38 ±2.4°, while the average slope in the CT-based planning protocol (iView) was 6.14 ±2.40°. Postoperative lateral tibial slope was determined to be 5.77 ±1.97°. The thickness of the posterior femoral cuts was measured intraoperatively and, in all cases, corresponded well to the targeted thickness of the cuts provided by the iView. The joint line was preserved in all cases and the average Insall-Salvati index was 1.078 ±0.11 pre- and 1.072 ±0.11 postoperatively. The fit of the implant components measured by over- or underhang was excellent throughout (< 1.01 mm).ConclusionsCustom-made bicompartmental knee arthroplasty can ensure optimized fitting and positioning of the implant with restoration of the leg axis. These implants could be considered as an alternative primary solution for knee surgeons treating bi-compartmental disease.

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Section: Methodsmentioning

confidence: 99%

Evaluation of implant fit and frontal plane alignment after bi-compartmental knee arthroplasty using patient-specific instruments and implants

Arnholdt

Kamawal

Holzapfel

et al. 2018

aoms

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“…2) the Insall-Salvati ratio and the modified Insall-Salvati ratio were measured and calculated [12]. The lateral patella tilt was quantified by analysis of skyline views [13,14] (Fig. 3).…”

Section: Radiographic Analysismentioning

confidence: 99%

Accurate implant fit and leg alignment after cruciate-retaining patient-specific total knee arthroplasty

Arnholdt

Kamawal

Horas

et al. 2020

BMC Musculoskelet Disord

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Background For improved outcomes in total knee arthroplasty (TKA) correct implant fitting and positioning are crucial. In order to facilitate a best possible implant fitting and positioning patient-specific systems have been developed. However, whether or not these systems allow for better implant fitting and positioning has yet to be elucidated. For this reason, the aim was to analyse the novel patient-specific cruciate retaining knee replacement system iTotal™ CR G2 that utilizes custom-made implants and instruments for its ability to facilitate accurate implant fitting and positioning including correction of the hip-knee-ankle angle (HKA). Methods We assessed radiographic results of 106 patients who were treated with the second generation of a patient-specific cruciate retaining knee arthroplasty using iTotal™ CR G2 (ConforMIS Inc.) for tricompartmental knee osteoarthritis (OA) using custom-made implants and instruments. The implant fit and positioning as well as the correction of the mechanical axis (hip-knee-ankle angle, HKA) and restoration of the joint line were determined using pre- and postoperative radiographic analyses. Results On average, HKA was corrected from 174.4° ± 4.6° preoperatively to 178.8° ± 2.2° postoperatively and the coronal femoro-tibial angle was adjusted on average 4.4°. The measured preoperative tibial slope was 5.3° ± 2.2° (mean +/− SD) and the average postoperative tibial slope was 4.7° ± 1.1° on lateral views. The joint line was well preserved with an average modified Insall-Salvati index of 1.66 ± 0.16 pre- and 1.67 ± 0.16 postoperatively. The overall accuracy of fit of implant components was decent with a measured medial overhang of more than 1 mm (1.33 mm ± 0.32 mm) in 4 cases only. Further, a lateral overhang of more than 1 mm (1.8 mm ± 0.63) (measured in the anterior-posterior radiographs) was observed in 11 cases, with none of the 106 patients showing femoral notching. Conclusion The patient-specific iTotal™ CR G2 total knee replacement system facilitated a proper fitting and positioning of the implant components. Moreover, a good restoration of the leg axis towards neutral alignment was achieved as planned. Nonetheless, further clinical follow-up studies are necessary to validate our findings and to determine the long-term impact of using this patient- specific system.

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Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery

Zhang

Zhou

Rao

et al. 2021

Arch Orthop Trauma Surg

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Patellanavigation bei computerassistierter Knie-TEP-Implantation

Abstract: In selected cases of patellofemoral problems, patella navigation is a helpful tool to evaluate patellofemoral tracking intraoperatively. Modifications of implant position and soft tissue measurements can then prevent postoperative patellofemoral maltracking.

Cited by 3 publications

References 12 publications

Evaluation of implant fit and frontal plane alignment after bi-compartmental knee arthroplasty using patient-specific instruments and implants

Evaluation of implant fit and frontal plane alignment after bi-compartmental knee arthroplasty using patient-specific instruments and implants

Accurate implant fit and leg alignment after cruciate-retaining patient-specific total knee arthroplasty

Investigation of femoral condyle height changes during flexion of the knee: implication to gap balance in TKA surgery

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