Knee Kinematics after Total Knee Arthroplasty (TKA): Influence of the Alignment.

A special issue of Journal of Functional Morphology and Kinesiology (ISSN 2411-5142).

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 12220

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Orthopaedics and Traumatology, School of Medicine, Stanford University, Stanford, CA, USA
Interests: Total Knee Arthroplasty, Periprosthetic Joint Infections, Gait analysis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Restoration of the individual’s knee anatomy and ligament tension is the final goal of any total knee arthroplasty (TKA) procedure. Historically, the goal of any TKA procedure was to achieve a neutral mechanical axis passing from the center of femoral head thorough the center of the knee joint line to the center of the ankle. Recently this dogma has been challenged and new, alternative alignment options have been proposed: anatomic (AA), adjusted mechanical (aMA), kinematic (KA), and restricted kinematic (rKA) alignment techniques represent this innovation. Recent technology innovations (computer assisted surgery, robotics, virtual reality softwares, pressure sensors) have been developed to help surgeons to be more precise in obtaining the desired limb alignment during TKA.

The influence of these new techniques on the postoperative knee kinematics has to be fully established and this special issue of "Journal of Functional Morphology and Kinesiology" has the goal of increase the knowledge on this interesting new topic.

Prof. Pier Francesco Indelli
Guest Editor

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Keywords

  • kinematics
  • gait analysis
  • TKA
  • alignment
  • total knee arthroplasty
  • knee
  • kinematic alignment
  • mechanical alignment
  • robotics
  • computer assisted surgery
  • navigation
  • surgical technique

Published Papers (2 papers)

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17 pages, 5149 KiB  
Article
Accuracy of Measuring Knee Flexion after TKA through Wearable IMU Sensors
by Ricardo Antunes, Paul Jacob, Andrew Meyer, Michael A. Conditt, Martin W. Roche and Matthias A. Verstraete
J. Funct. Morphol. Kinesiol. 2021, 6(3), 60; https://0-doi-org.brum.beds.ac.uk/10.3390/jfmk6030060 - 05 Jul 2021
Cited by 8 | Viewed by 6713
Abstract
Wearable sensors have the potential to facilitate remote monitoring for patients recovering from knee replacement surgery. Using IMU sensors attached to the patients’ leg, knee flexion can be monitored while the patients are recovering in their home environment. Ideally, these flexion angle measurements [...] Read more.
Wearable sensors have the potential to facilitate remote monitoring for patients recovering from knee replacement surgery. Using IMU sensors attached to the patients’ leg, knee flexion can be monitored while the patients are recovering in their home environment. Ideally, these flexion angle measurements will have an accuracy and repeatability at least on par with current clinical standards. To validate the clinical accuracy of a two-sensor IMU system, knee flexion angles were measured in eight subjects post-TKA and compared with other in-clinic angle measurement techniques. These sensors are aligned to the patients’ anatomy by taking a pose resting their operated leg on a box; an initial goniometer measurement defines the patients’ knee flexion while taking that pose. The repeatability and accuracy of the system was subsequently evaluated by comparing knee flexion angles against goniometer readings and markerless optical motion capture data. The alignment pose was repeatable with a mean absolute error of 1.6 degrees. The sensor accuracy through the range of motion had a mean absolute error of 2.6 degrees. In conclusion, the presented sensor system facilitates a repeatable and accurate measurement of the knee flexion, holding the potential for effective remote monitoring of patients recovering from knee replacement surgery. Full article
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11 pages, 1390 KiB  
Article
Kinematic Comparison between Medially Congruent and Posterior-Stabilized Third-Generation TKA Designs
by Stefano Ghirardelli, Jessica L. Asay, Erika A. Leonardi, Tommaso Amoroso, Thomas P. Andriacchi and Pier Francesco Indelli
J. Funct. Morphol. Kinesiol. 2021, 6(1), 27; https://0-doi-org.brum.beds.ac.uk/10.3390/jfmk6010027 - 15 Mar 2021
Cited by 11 | Viewed by 4383
Abstract
Background: This study compares knee kinematics in two groups of patients who have undergone primary total knee arthroplasty (TKA) using two different modern designs: medially congruent (MC) and posterior-stabilized (PS). The aim of the study is to demonstrate only minimal differences between [...] Read more.
Background: This study compares knee kinematics in two groups of patients who have undergone primary total knee arthroplasty (TKA) using two different modern designs: medially congruent (MC) and posterior-stabilized (PS). The aim of the study is to demonstrate only minimal differences between the groups. Methods: Ten TKA patients (4 PS, 6 MC) with successful clinical outcomes were evaluated through 3D knee kinematics analysis performed using a multicamera optoelectronic system and a force platform. Extracted kinematic data included knee flexion angle at heel-strike (KFH), peak midstance knee flexion angle (MSKFA), maximum and minimum knee adduction angle (KAA), and knee rotational angle at heel-strike. Data were compared with a group of healthy controls. Results: There were no differences in preferred walking speed between MC and PS groups, but we found consistent differences in knee function. At heel-strike, the knee tended to be more flexed in the PS group compared to the MC group; the MSKFA tended to be higher in the PS group compared to the MC group. There was a significant fluctuation in KAA during the swing phase in the PS group compared to the MC group, PS patients showed a higher peak knee flexion moment compared to MC patients, and the PS group had significantly less peak internal rotation moments than the MC group. Conclusions: Modern, third-generation TKA designs failed to reproduce normal knee kinematics. MC knees tended to reproduce a more natural kinematic pattern at heel-strike and during axial rotation, while PS knees showed better kinematics during mid-flexion. Full article
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