The Arthroscopic Evaluation and Characteristics of Severe Polyethylene Wear in Total Knee Arthroplasty

Mintz, Leslie J.; Ak, Tsao; Cr, McCrae; Sd, Stulberg; Wright, Timothy M.

doi:10.1097/00003086-199112000-00032

Cited by 62 publications

(34 citation statements)

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“…Surgeons' recommendations are based on subjective opinions without quantitative measurements of knee forces and are not always consistent [20,37]. The results of clinical outcomes are mixed, with some studies reporting increased component failure in more active patients and others reporting no difference [8,22,30,35,37,38]. We directly measured tibial forces in vivo during exercise and various recreational activities at 1 year postoperatively ( Fig.…”

Section: Recreation and Exercisementioning

confidence: 99%

The 2011 ABJS Nicolas Andry Award: ‘Lab’-in-a-Knee: In Vivo Knee Forces, Kinematics, and Contact Analysis

D’Lima

Patil

Steklov

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Tibiofemoral forces are important in the design and clinical outcomes of TKA. We developed a tibial tray with force transducers and a telemetry system to directly measure tibiofemoral compressive forces in vivo. Knee forces and kinematics traditionally have been measured under laboratory conditions. Although this approach is useful for quantitative measurements and experimental studies, the extrapolation of results to clinical conditions may not always be valid. Questions/purposes We therefore developed wearable monitoring equipment and computer algorithms for classifying and identifying unsupervised activities outside the laboratory. Methods Tibial forces were measured for activities of daily living, athletic and recreational activities, and with orthotics and braces, during 4 years postoperatively. Additional measurements included video motion analysis, EMG, fluoroscopic kinematic analysis, and ground reaction force measurement. In vivo measurements were used to evaluate computer models of the knee. Finite element models were used for contact analysis and for computing knee kinematics from measured knee forces. A thirdgeneration system was developed for continuous monitoring of knee forces and kinematics outside the laboratory using a wearable data acquisition hardware. Results By using measured knee forces and knee flexion angle, we were able to compute femorotibial AP translation (À12 to +4 mm), mediolateral translation (À1 to 1.5 mm), axial rotation (À3°to 12°), and adduction-abduction (À1°t o +1°). The neural-network-based classification system was able to identify walking, stair-climbing, sit-to-stand, and stand-to-sit activities with 100% accuracy. Conclusions Our data may be used to improve existing in vitro models and wear simulators, and enhance prosthetic designs and biomaterials.

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Section: Recreation and Exercisementioning

confidence: 99%

The 2011 ABJS Nicolas Andry Award: ‘Lab’-in-a-Knee: In Vivo Knee Forces, Kinematics, and Contact Analysis

D’Lima

Patil

Steklov

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Há algum tempo a artroscopia vem sendo indicada como método diagnóstico e terapêutico para sintomas álgicos pós-artroplastia do joelho (6) . A artroscopia pode levar à indicação mais adequada de revisão de um componente ou de toda a prótese em casos de dúvida diagnóstica, sendo muito útil para a detecção de soltura de componentes protéticos, corpos livres intra-articulares, fraturas ou outras anormalidades (7)(8)(9)(10)(11)(12) .…”

Section: Discussionunclassified

“…A artroscopia pode levar à indicação mais adequada de revisão de um componente ou de toda a prótese em casos de dúvida diagnóstica, sendo muito útil para a detecção de soltura de componentes protéticos, corpos livres intra-articulares, fraturas ou outras anormalidades (7)(8)(9)(10)(11)(12) . Já se demonstrou, em trabalhos internacionais, que a artroscopia pode ser usada ainda como método de coleta de material por suspeita de infecção ou para evacuação de hematoma intraarticular (6,7,13) , o que não foi necessário em nenhum caso neste estudo. No entanto, nenhum estudo prospectivo a esse respeito havia sido realizado com casuística brasileira até o momento e o presente trabalho serve para mostrar que em nosso meio o procedimento também é viável.…”

Section: Discussionunclassified

“…Diversos autores (2,6,8,(14)(15)(16)(17) demonstraram a importân-cia da artroscopia como método diagnóstico e terapêuti-co para artrofibrose do joelho, levando a melhora significativa do quadro de dor e função do joelho acometido. Neste trabalho, não foi encontrada artrofibrose articular, mas apenas casos de fibrose localizada, que foi chamada de "ciclope" (2) .…”

Section: Discussionunclassified

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Artroscopia diagnóstica e terapêutica em pacientes sintomáticos pós-artroplastia do joelho

Severino¹,

Souza²,

Severino³

2009

Rev. bras. ortop.

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RESUMOObjetivos: Verificar o valor da artroscopia na investigação e no tratamento da dor no joelho pós-artroplastia não esclarecida por exames clínicos e subsidiários. Métodos: Entre 402 pacientes submetidos à artroplastia total ou unicompartimental de setembro de 2001 a abril de 2007 num hospital universitário público, 17 deles apresentavam dor na articulação protética, sem diagnóstico clínico, radiográfico, laboratorial, cintilográfico ou por ressonância nuclear magnética. Todos foram submetidos à artroscopia e a sintomatologia foi avaliada pela escala de Lysholm, comparando-se os períodos pré e pós-artros copia. Os achados intraoperatórios foram registrados. Resultados: O procedimento foi eficaz para alívio do sintoma doloroso em 14 dos 17 pacientes (82,35%). A mediana do escore de Lysholm subiu de 36 pontos antes da artroscopia para 94 pontos após (p < 0,001). A maioria dos pacientes (12) apresentava como diagnóstico artroscópico um quadro de fibrose conhecido como "ciclope"; nos outros cinco pacientes foi verificada sinovite anterior. Todos foram tratados com ressecção. Conclusões: A artroscopia do joelho pós-artroplastia em pacientes com dor persistente a diagnosticar revela quadros de artrofibrose localizada ("ciclopes") ou de sinovite, que podem ser tratados pelo mesmo procedimento, resultando em melhora do quadro álgico. Descritores

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“…[4], which is 72 months. There were also studies on the massive delaminating of the polyethylene occurred earlier [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Knee Wear Prediction of UHMWPE Tibial Insert Using VIPRO Platform

Capitanu¹,

Vlădăreanu²,

Florescu³

2015

JMEA

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Abstract:The failure mechanism was postulated as a combination of the high level of loading during normal activities and a non-conforming contact mechanism between the femoral condyles and the tibial insert. The question that arises is: could be this phenomenon evaluated quantitatively a priori, e.g., could be the failure due to delamination wear predicted? In order to do some finite element simulations were performed to dynamically determinate the contact area and contact pressure for three different activities. The results obtained using VIPRO platform lead to the conclusion that many clinically reported failures of the tibial tray are caused by the adhesive and fatigue wear.

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The Arthroscopic Evaluation and Characteristics of Severe Polyethylene Wear in Total Knee Arthroplasty

Cited by 62 publications

References 0 publications

The 2011 ABJS Nicolas Andry Award: ‘Lab’-in-a-Knee: In Vivo Knee Forces, Kinematics, and Contact Analysis

The 2011 ABJS Nicolas Andry Award: ‘Lab’-in-a-Knee: In Vivo Knee Forces, Kinematics, and Contact Analysis

Artroscopia diagnóstica e terapêutica em pacientes sintomáticos pós-artroplastia do joelho

The Knee Wear Prediction of UHMWPE Tibial Insert Using VIPRO Platform

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