Valgus position of the femoral component causes abnormal kinematics in the presence of medial looseness in total knee arthroplasty: a computer simulation model of TKA for valgus knee osteoarthritis

Nishitani, Kohei; Kuriyama, Shinichi; Nakamura, Shinichiro; Morita, Yoshifumi; Ito, Hiromu; Matsuda, Shinya

doi:10.1007/s00167-018-5264-0

Cited by 11 publications

(9 citation statements)

References 29 publications

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“…Previous studies have focused on evaluating the effect of alignment outliers ( Fang et al, 2009 ; Longstaff et al, 2009 ; Lombardi et al, 2011 ; Ritter et al, 2011 ; Lerner et al, 2015 ; Kang et al, 2017 ; Lee et al, 2018 ; Nishitani et al, 2019 ). Various studies using computational methods evaluated the contact stress and force at more than 3° of varus/valgus alignment.…”

Section: Introductionmentioning

confidence: 99%

“… Lerner et al (2015) constructed a dynamic simulation model and calculated knee contact forces up to 8° varus- and valgus-aligned TKA. A musculoskeletal knee simulator model was used to evaluate the knee contact force and kinematics of a 7° valgus alignment model while providing 4 mm of slack on the medial collateral ligament (MCL) during deep-knee bend cycles ( Nishitani et al, 2019 ). Therefore, evaluating the biomechanical effects of moderate varus and valgus alignments of less than 3° is necessary.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study

Ro¹,

Kang

et al. 2022

Front. Bioeng. Biotechnol.

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The purposes of this study were to develop a cruciate-retaining total knee arthroplasty musculoskeletal model, which enables the adjustment of ligament length and implant alignment; validate the model; and evaluate the effects of varus/valgus alignment adjustment and unbalanced medial/lateral ligament laxity during gait. A cruciate-retaining total knee arthroplasty musculoskeletal model was constructed and validated against the in vivo contact forces. This model was transformed to 2° varus/valgus alignment of femoral or tibial replacement models and 2° medial/lateral laxity models. The contact forces and ligament tensions of the adjusted models were calculated. The contact forces in the model showed good agreement with the in vivo contact forces. Valgus replacement alignment with balanced ligament models showed a lower contact force at the medial compartment than at the neutral alignment model, whereas the varus replacement alignment with balanced ligament models showed a greater contact force at the medial compartment and medial/posterior cruciate ligament tension. The medial laxity with neutral alignment model showed a similar contact force with decreased medial ligament tension compared to the balanced neutral alignment model, whereas the lateral laxity with the neutral alignment model showed a greater contact force and decreased lateral ligament tension. The cruciate-retaining total knee arthroplasty model was validated using in vivo contact forces (r = 0.939) Two degrees of valgus alignment adjustment with balanced ligament or neutral alignment with 2° of medial laxity can be safe without increasing contact force or ligament tension compared to neutral alignment with a balanced extension gap. However, 2° of varus alignment adjustment with balanced ligament or neutral alignment with 2° of lateral laxity may be unfavorable due to the overloading of the joints and knee ligaments.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study

Ro¹,

Kang

et al. 2022

Front. Bioeng. Biotechnol.

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“…Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis, and many studies have suggested good long-term survivorship as well as better kinematics, lower pain level, and complications in osteoarthritis knee. [1–3] However, the inflammatory response following TKA is obvious and a result of the cumulative effects of anesthesia and surgical stress. [4,5] As previously reported, inflammation is associated with postsurgical pain, [6,7] postoperative nausea and vomiting (PONV), [8,9] fatigue, [10,11] resulting in increased dissatisfaction, [12,13] and impeding functional recovery.…”

Section: Introductionmentioning

confidence: 99%

Perioperative combined administration of tranexamic acid and dexamethasone in total knee arthroplasty—benefit versus harm?

Lin

et al. 2019

Medicine

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Background: The purpose of this study was to investigate the benefits and harm of combined administration of tranexamic acid (TXA) and dexamethasone (Dexa) in total knee arthroplasty (TKA). Methods: A total of 88 consecutive patients undergoing TKA for knee osteoarthritis were stratified in 2 groups. All surgeries were performed under general anesthesia. Brief, patients in the TXA + Dexa group (n = 45) received 10 mg Dexa just after the anesthesia, and repeated at 24 hours after the surgery; and patients in the TXA group (n = 43) received 2 ml of normal saline solution at the same time. The measured outcomes were the C-reactive protein (CRP) and interleukin-6 (IL-6) from preoperatively to postoperatively, and postoperative nausea and vomiting (PONV), fatigue, range of motion (ROM), length of stay (LOS), and the analgesic and antiemetic rescue consumption Results: The level of CRP and IL-6 in the TXA + Dexa group were lower than that in the TXA group at 24 hours ( P < .001, P < .001), 48 hours ( P < .001, P < .001), and 72 hours ( P < .001, P < .001) after the surgery. The pain scores in the TXA + Dexa group were lower during walking at 24 hours ( P < .001), 48 hours ( P < .001), and 72 hours ( P < .001) and at rest at 24 hours ( P = .022) after the surgery. Patients in the TXA + Dexa group had a lower nausea score, the incidence of PONV, fatigue, and the analgesic and antiemetic rescue consumption, and had a greater ROM than that in the TXA group. No significant differences were found in LOS and complications. Conclusion: The combined administration of TXA + Dexa significantly reduced the level of postoperative CRP and IL-6, relieve postoperative pain, ameliorate the incidence of POVN, provide additional analgesic and antiemetic effects, reduce postoperative fatigue, and improve ROM, without increasing the risk of complications in primary TKA.

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“…See Table 5. Gonitis is a common clinical degenerative change of the lower extremities that occurs mostly in the middleaged and elderly, is more common in the 50-60 y age group and is more common in women than men, which is associated with disturbed sex hormone levels and exacerbated bone loss after women enter menopause [8] .…”

Section: Resultsmentioning

confidence: 99%

Effects of Yougui Pill Combined With Diacerein on Gonitis and Serum Levels of Toll-Like Receptor 4, Matrix Metalloproteinase-3 and Nitric Oxide

Ma¹,

Zhou²,

Yu³

et al. 2021

IJPS

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To observe the efficacy of Yougui pill combined with diacerein on gonitis and the effects of serum Tolllike receptor 4, matrix metalloproteinase-3 and nitric oxide. A total of 132 patients with gonitis treated in our hospital from January 2019 to October 2020 were selected and divided according to their treatment regimen. Efficacy: After 8 w of treatment, 28 patients had complete remission in the observation group, accounting for 42.42 %, 25 patients had partial remission, accounting for 37.88 % and 8 patients had remission, accounting for 12.12 %; in the control group, 14 patients had complete remission, accounting for 21.21 %, 21 patients had partial remission, accounting for 31.82 % and 18 patients had remission, accounting for 27.27 %; in the observation group, the overall response rate was higher than that in the control group and it was statistically significant (p<0.05). Serum: After 8 w of treatment, Toll-like receptor 4, matrix metalloproteinase-3 and nitric oxide, erythrocyte sedimentation rate and C-reactive protein in both groups were largely decreased compared with those before treatment (p<0.05) and after 8 w of treatment in the observation group, Toll-like receptor 4, matrix metalloproteinase-3 and nitric oxide, erythrocyte sedimentation and C-reactive protein were lower compared with the control group (p<0.05). Bone and joint function: The pain, daily activities, stiffness and total scores in both groups after 8 w of treatment were greatly decreased compared with those before treatment (p<0.05) and the above scores were lower in the observation group after 8 w of treatment compared with those in the control group (p<0.05). Safety: In the observation group, gastric discomfort occurred in 2 patients, dry mouth in 3 patients and fatigue in 1 patient; in the control group, gastric discomfort occurred in 2 patients and dry mouth in 1 patient; the rate of adverse effects in the observation group was not statistically different from that in the control group (p>0.05). The combination of Yougui pill and diacerein improved the efficacy and decreased the expression of serum related factors without increasing adverse effects in patients with gonitis.

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Valgus position of the femoral component causes abnormal kinematics in the presence of medial looseness in total knee arthroplasty: a computer simulation model of TKA for valgus knee osteoarthritis

Cited by 11 publications

References 29 publications

Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study

Biomechanical Effect of Coronal Alignment and Ligament Laxity in Total Knee Arthroplasty: A Simulation Study

Perioperative combined administration of tranexamic acid and dexamethasone in total knee arthroplasty—benefit versus harm?

Effects of Yougui Pill Combined With Diacerein on Gonitis and Serum Levels of Toll-Like Receptor 4, Matrix Metalloproteinase-3 and Nitric Oxide

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