The Oxford medial unicompartmental knee replacement was designed to reproduce normal mobility and forces in the knee, but its detailed effect on the patellofemoral joint has not been studied previously. We have examined the effect on patellofemoral mechanics of the knee by simultaneously measuring patellofemoral kinematics and forces in 11 cadaver knee specimens in a supine leg-extension rig. Comparison was made between the intact normal knee and sequential unicompartmental and total knee replacement. Following medial mobile-bearing unicompartmental replacement in 11 knees, patellofemoral kinematics and forces did not change significantly from those in the intact knee across any measured parameter. In contrast, following posterior cruciate ligament retaining total knee replacement in eight knees, there were significant changes in patellofemoral movement and forces. The Oxford device appears to produce near-normal patellofemoral mechanics, which may partly explain the low incidence of complications with
As part of the step-wise validation of a new prosthesis (TMK), we previously published the 1 year results of a randomised controlled trial in patients undergoing bilateral knee replacement [Price A., Rees J., Beard D., Juszczak E. et al. A mobile-bearing total knee prosthesis compared with a fixed-bearing prosthesis. JBJS B 2003;85-B-1:62-7.]. Forty patients had the new mobile-bearing prosthesis implanted in one knee and an established fixed-bearing device in the other (AGC). We now report the 3 year status of these patients and, in addition, review a separate multi-centre cohort of 172 patients who had undergone unilateral arthroplasty with the TMK. No significant differences were found in outcome (American Knee Society Score and Oxford Knee Score) between the two prostheses. The greater incidence of clicking in the mobile-bearing knee, reported in the previous review, persisted (TMK=48%, AGC=30%). The presence of this mechanical noise was found to have no relationship with outcome in either of the
PURPOSE: Studies have shown that after total knee arthroplasty neither normal biomechanics nor function is obtained. Selective resurfacing of diseased compartments could be a solution. A narrative review of the available literature on bicompartmental arthroplasty is presented. METHODS: A literature review of all peer reviewed published articles on bicompartmental arthroplasty of the knee was performed. Bicompartmental arthroplasty is by definition the replacement of the tibiofemoral and the patellofemoral joint. It can be performed with a modular unlinked or a monolithic femoral component. RESULTS: Bicompartmental arthroplasty performed with modular components obtains good to excellent results at ± 10 years follow-up. Function and biomechanics are superior to total knee arthroplasty. Modern monolithic femoral components are reported to give early failure and high revision rates and should be avoided. CONCLUSION: Modular bicompartmental arthroplasty is an excellent alternative to treat bicompartmental
Background - Limited previous findings have detailed biomechanical advantages following implantation with mobile bearing (MB) prostheses after total knee replacement (TKR) surgery during walking. The aim of this study was to compare three dimensional spatiotemporal, kinematic, and kinetic parameters during walking to examine whether MBs offer functional advantages over fixed bearing (FB) designs.. Methods - Sixteen patients undergoing primary unilateral TKR surgery were randomised to receive either a FB (n = 8) or MB (n = 8) total knee prosthesis. Eight age and gender matched controls underwent the same protocol on one occasion. A 12 camera Vicon system integrated with four force plates was used. Patients were tested pre-surgery and nine months post-surgery.. Results - No significant differences between FB and MB groups were found at any time point in the spatiotemporal parameters. The MB group was found to have a significantly reduced frontal plane knee range of motion (ROM) at pre-surgery than ...
Satisfactory selection criteria are essential for the successful outcome of unicompartmental knee arthroplasty (UCA). We report the frequency of revision of the Oxford medial unicompartmental arthroplasty in knees previously treated for anteromedial osteoarthritis by high tibial osteotomy (HTO). The combined results from three sources were used to allow statistical analysis of this uncommon subgroup. In the combined series of 631 knees (507 patients) which had medial unicompartmental replacement, 613 were primary procedures and 18 were for a failed HTO. The mean follow-up times of the two groups were similar (5.8 years and 5.4 years, respectively). At review, 19 (3.1%) of the primary procedures and five (27.8%) of those undertaken for a failed HTO had been revised to total knee replacement. Survival analysis revealed the ten-year cumulative survivals to be 96% and 66%, respectively. The log-rank comparison of these survivals revealed a highly significant difference (p | 0.0001). We recommend that the
Introduction. Unicompartmental arthroplasty of the knee in patients with isolated medial osteoarthritis gives good results, but survival is inferior to that of total knee prosthesis. Knees may fail because positioning of the prosthesis has been suboptimal. The aim of this study was to investigate the influence of the tibial slope on the rate of wear of amedial fixed-bearing unicompartmental knee arthroplasty. Materials and Methods. We simulated wear on a medial fixed-bearing unicompartmental knee prosthesis (Univation) in vitro with a customised, four-station, and servohydraulic knee wear simulator, which exactly reproduced the walking cycle (International Organisation for Standardisation (ISO) 14243-1: 2002(E)). The medial prostheses were inserted with 3 different posterior tibial slopes: 0 degrees, 4 degrees, and 8 degrees (n = 3 in each group). Results. The wear rate decreased significantly between 0 degrees and 4 degrees slope from 10.4 (SD 0.62) mg/million cycles to 3.22 (SD 1.71) ...
With medial unicompartmental osteoarthritis (OA) there is occasionally a full-thickness ulcer of the cartilage on the medial side of the lateral femoral condyle. It is not clear whether this should be considered a contraindication to unicompartmental knee replacement (UKR). The aim of this study was to determine why these ulcers occur, and whether they compromise the outcome of UKR. Case studies of knees with medial OA suggest that cartilage lesions on the medial side of the lateral condyle are caused by impingement on the lateral tibial spine as a result of the varus deformity and tibial subluxation. Following UKR the varus and the subluxation are corrected, so that impingement is prevented and the damaged part of the lateral femoral condyle is not transmitting load. An illustrative case report is presented. Out of 769 knees with OA of the medial compartment treated with the Oxford UKR, 59 (7.7%) had partial-thickness cartilage loss and 20 (2.6%) had a full-thickness cartilage deficit on the medial
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Dr Lige Kaplan in Scottsdale, Phoenix and Glendale, AZ performs unicompartmental knee replacement surgery also called partial knee replacement.
These total knee prostheses permit flexion and extension and allow for a limited rotation. The linked total knee prostheses, however, prevent movements to both sides (abduction and adduction) of the knee joint. That is their purpose: to provide the total knee with intrinsic side stability.. The limited amount of rotation, that these prostheses allow, improves gait and decreases stresses on the bone -skeleton interface created by walk and other activities. Thus, in contrast to the old true hinged total knees, the linked total knee prostheses have lover rates of complications. (more…). Read More ...
The secondary outcomes evaluate the early and late postoperative results concerning the incidence and type of postoperative averse events, duration of hospital stay, use of pain medication, need for blood transfusion, HB level, drain production, operation parameters, knee swelling, Knee injury and Osteoarthritis Outcome Score (KOOS), Straight leg raise, ambulatory status, single leg stance, ability to walk stairs, X-ray parameters, patient satisfaction, need for home care, resumption of work, chair rise ability, walking speed, amount of pain during rest and activity, and economical costs of the Scorpio knee prosthesis following the Lazirush concept and compare this with a matched group of patients undergoing a Scorpio knee prosthesis following the Joint Care concept. Concerning the secondary outcome measures a difference will be made between continuous outcome variables and categorical outcome variables. Continuous outcome variables and their differences will be analysed with parametrical ...
When the Oxford unicompartmental meniscal bearing arthroplasty is used in the lateral compartment of the knee, 10% of the bearings dislocate. A radiological review was carried out to establish if dislocation was related to surgical technique. The postoperative radiographs of 46 lateral unicompartmental arthroplasties were analysed. Five variables which related to the position and alignment of the components were measured. Dislocations occurred in six knees. Only one of the five variables, the proximal tibial varus angle, had a statistically significant relationship to dislocation. This variable quantifies the height of the lateral joint line. The mean proximal tibial varus angle for knees the bearings of which had dislocated was 9 degrees and for those which had not it was 5 degrees. In both groups it was greater than would be expected in the normal knee (3 degrees). Our study suggests that a high proximal tibial varus angle is associated with dislocation. The surgical technique should be modified to
Sales, means the sales volume of Knee Prosthesis Revenue, means the sales value of Knee Prosthesis This report studies sales (consumption) of Knee Prosthesis in Europe market, especially in Germany, UK, France, Russia, Italy, Benelux and Spain, focuses on top players in these countries, with sales, price, revenue and market share for each player in these Countries, covering Zimmer Holdings, I
Background and purpose: During knee joint distraction (KJD) treatment, using an external fixation-frame, pin-tract infections frequently occur. These local skin infections, although treated successfully with oral antibiotics, might lead to latent infections. This raises concern about subsequent placement of a total knee prosthesis (TKP). This study evaluates the first five cases in which patients had to be treated with TKO after KJD failure.. Patients and methods: An overall survival analysis of the first 26 patients treated with KJD revealed five failures, because of declining efficacy over time. These patients were treated with TKP. Complications of these TKPs are described and all cases were compared with age and gender matched primary-TKP-controls. WOMAC and VAS pain scores were assessed before and after TKP treatment.. Results: The mean survival time of the five KJD before TKP was 61 ± 15 months (range 45-84 months). No peri-operative complications were registered and none of the patients ...
The following is what can be expected prior to Unicompartmental Knee Replacement Surgery: Examinations: X-rays will be taken and a CT scan or MRI may...
Zimmer PSI Knee System For Use with the NexGen Complete Knee System Surgical Technique TOC Zimmer PSI Knee Surgical Technique Zimmer PSI Knee Surgical Technique Table of Contents Intra-Operative Guide
The primary objective of this study is to assess the survivorship of the P.F.C. fixed bearing knee system using a cobalt chrome tibial tray and moderately cross-linked polyethylene insert at 5-Years. The secondary objectives of this investigation are to evaluate additional clinical outcomes to provide further information on the performance of the P.F.C. fixed bearing knee system using a moderately cross-linked polyethylene insert and cobalt chrome tibial tray. These outcomes will include Radiographic assessment, American Knee Society Score, Oxford Knee Score and SF-12 ...
Methodology: This study will be a randomized, multi-center evaluation comparing N2vac polyethylene inserts and patellas with X3 inserts and patellas when used in the Triathlon PS total knee system.. Study Duration: 12-18 month enrollment period + 10 year follow-up for each case years total duration. Multi-centre study. Objectives. Primary: To compare the 10 year implant survival of the Triathlon PS total knee system when X3 polyethylene components are used to the same knee system when N2Vac components are used.. Secondary: To compare pain, function, radiographic outcomes, and health related quality of life of subjects in both treatment groups. Safety will be assessed by comparison of adverse events between the groups.. Number of Subjects 384 cases (197 each group) ...
Pre-revision radiographs showed the presence of both full and partial RLL. On contact radiographs of 5 mm thick sections of the interface the total percentage of radiolucency ranged from 0 to 90% between patients. There was no consistent pattern for the distribution of radiolucency. Histological assessment demonstrated that under every tibial component there were areas where there was direct contact and interdigitation between bone and cement. The amount of direct bone-cement contact was between 19% and 95% of the tibial tray surface area. The remaining tissue was mainly fibrocartilage but there was also fibrous tissue. The presence of radiolucency was strongly inversely correlated with the percentage of cement-bone contact ...
In unicondylar knee prostheses, the relative angle and congruency of the femoral against the tibial component is not mechanically constrained and may vary with the surgical implantation technique. The contact area between both components was measured with increasing varus (0-20 degrees) and flexion angles (-20 degrees to 90 degrees) in five prosthesis models in the laboratory. The contact area varied with the relative position of the components and was critically reduced up to 70% at a varus range between ,5 degrees and ,25 degrees. The importance of relative malpositioning of the femoral and tibial components may be underestimated and reduces the contact area of unicondylar prostheses decisively, independent from the limb axis. This increases local pressure and may thus importantly contribute to increased wear and early loosening. ...
This is my first encounter with this issue. Our new knee surgeon performed a total knee replacement due to a periprosthetic supracondylar femur fractu
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Bicompartmental knee resurfacing is a less invasive surgical alternative to total knee replacement surgery for patients who have only 2 of the 3 compartments of the knee damaged by arthritis.
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Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. Dr Tim Small in Darlinghurst and Sydney, NSW offers unicondylar knee replacement.
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A knee prosthesis comprises (i) a femoral component having a medial condyle and a lateral condyle and (ii) a tibial component. The rolling surface of the medial condyle is part-spherical and the tibial component has a complementary part-spherical depression in its upper surface to receive the medial condyle. The bearing surface of the lateral condyle includes a posterior part which has a curvature in a substantially sagittal plane about a first point on a transverse axis that passes through the center of curvature of the rolling surface of the medial condyle and an anterior part which has a curvature in the same plane about a point that lies on a second transverse axis parallel to, and anterior to, the first transverse axis. The tibial component has an arcuate groove to receive the lateral condyle and to permit, in flexion of the knee after implantation, limited anterior/posterior movement of the lateral side of the tibia relative to the femur. In flexion of the knee the posterior part of the rolling
Femoral component for a knee prosthesis adapted to cooperate with an insert attached to a tibial plateau anchored at the upper end of a tibia. The femoral component is adapted to be anchored at a lower end of a femur, the femoral component including a first lateral condyle, a second lateral condyle, and an intercondylar space disposed between the first and second condyles for receiving a third removably fixed condyle. The third condyle is removable from the intercondyle space while the femoral component remains moveably engaged with the tibial plateau. The third condyle is adapted to provide posterior stabilization of the prosthesis during flexion between the tibia and the femur when the posterior cruciate ligament is no longer able to substantially perform its function.
A unicompartmental knee prosthesis for implantation into a knee joint includes a body having a substantially elliptical shape in plan and a pair of contoured opposed faces including a first face and a second face, the second face including a concave surface. The prosthesis is free of fixation to a permanent location within the knee joint compartment. A peripheral edge extends between the faces and has a first side, a second side opposite the first side, and a first end and a second end opposite the first end, the body including a cusp comprising a reverse curve downward from to the first face at one of the first and second ends. A first dimension D is defined by the first end and the second end, and a second dimension F is defined by the first side and the second side. A coordinate system origin (CSO) is at an intersection of D and F, the body including a material thickness at the CSO, where the dimension F is from about 0.25 to about 1.5 of the dimension D.
There are numerous Total Knee Arthroplasty systems in the market with each system having different sets of instrumentation and different techniques that accompany each set. There are several things that make the surgical technique of Axis Knee System unique.. The goal of any Total Knee Arthroplasty surgery is to align the lower limb. This alignment is guided by three points namely the center of the femoral head, the center of the knee and the center of the ankle. It is relatively easy to get the center of the knee and the center of the ankle because they are accessible during surgery. The femoral head is deep in the hip and is outside the surgical field. Most systems will use guide rods inserted in the femoral canal and reference off of that, getting an average value in degrees that they assume will point to the femoral head. Some use preoperative x-rays to locate the femoral head and put a physical marker that the surgeon can palpate during surgery. More modern systems use expensive computer ...
Introduced over 20 years ago the SMILES knee implant was developed by Professor Peter Walker and is Stanmore Implants platform knee which provides the surgeon with a choice of fixed or rotating hinged knees. Click here to find out more.
Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement.
Unicompartmental knee replacement - This procedure involves replacing the damaged inside section of the knee. Learn about costs, procedure and recovery.
Dr. Shekhar is one of the few surgeons in India who offers his patients the option of the Persona Knee which provides a more natural feel than any other implant in the market today. The Persona System makes the most clinically successful knee replacement more personalized than ever by focusing on the unique needs of the patient ensuring that his or her size is matched perfectly. Surgeons trust the clinical success of this knee system because of the clinical research and development on this knee system. The research utilized analytics from both male and female genders and 1,500 different bone types from 26 different ethnicities creating the most anatomically accurate knee implant. Dr. Shekhar Agarwal regularly does knee replacement surgery using the Persona Knee and the results have been very satisfactory. Case examples of the Persona Knee are shown below.. Persona Knee Implant. ...
Although each procedure varies, generally, surgery to replace a knee usually lasts about two hours. After the damaged bone and cartilage of the knee is removed, the orthopaedic surgeon will place the new artificial knee in its place.. The two most common types of knee prostheses used in replacement surgeries are cemented prosthesis and uncemented prosthesis. Sometimes, a combination of the two types is used to replace a knee. A knee prosthesis is made up of metal with ceramic and/or plastic. A cemented prosthesis is attached to the bone with a type of epoxy. An uncemented prosthesis attaches to the bone with a fine mesh of holes on the surface, in order for the bone to grow into the mesh and attach naturally to the prosthesis.. The prosthesis (artificial knee) is comprised of the following three components:. ...
Although each procedure varies, generally, surgery to replace a knee usually lasts about two hours. After the damaged bone and cartilage of the knee is removed, the orthopaedic surgeon will place the new artificial knee in its place.. The two most common types of knee prostheses used in replacement surgeries are cemented prosthesis and uncemented prosthesis. Sometimes, a combination of the two types is used to replace a knee. A knee prosthesis is made up of metal with ceramic and/or plastic. A cemented prosthesis is attached to the bone with a type of epoxy. An uncemented prosthesis attaches to the bone with a fine mesh of holes on the surface, in order for the bone to grow into the mesh and attach naturally to the prosthesis.. The prosthesis (artificial knee) is comprised of the following three components:. ...
Knee prosthesis in advanced osteoarthritis of the knee joint. Find out more about the surgical procedures, risks and success rates.
The invention relates to a knee prosthesis which produces the required torque and angular velocities along the entire drive chain solely in rotation. For this purpose, the torque is transmitted from a driving motor to the knee over a helical bevel gear.
The Reconstruction franchise, which contains the companys knee and hip implants, grew 3 percent to $1.5 billion in sales. Knee implants were the single largest revenue producer for the company, capturing 20 percent of total sales and rising 6 percent to $932 million from the previous year. The 2016 launch of the Anthem Total Knee System was one aspect driving growth here. Anthems launch caters to the growing trend of personalized orthopedic devices, designed from both intraoperative measurements and patient CT analysis to create a knee offering fit for a wide variety of patients. The limited market release of the Journey II XR bi-cruciate retaining knee implant and gains from the companys 2015 purchase of the Zimmer Unicompartmental High Flex Knee for the U.S. market also fueled growth in this sector. The Blue Belt Technologies acquisition also began to add to the gain, as in July 2016 the Navio system was used for its first-ever robotics-assisted total knee replacement. Because less than 10 ...
Total Joint Orthopedics (TJO) announced today a new collaboration with THINK Surgical®, Inc., an advanced orthopedic robot technology company based in Fremont, CA. Under the terms of the agreement, THINK Surgical will develop software allowing TJOs Klassic® Knee System to be implanted using THINKs TSolution One® Total Knee Application and both companies will co-market the solution upon 510(k) clearance to use the Klassic® Knee System with the TSolution One Total Knee Application.
An implantable knee prosthesis includes a two-piece body having a substantially elliptical shape in plan and including a first piece and a second piece. The first piece is a tibial piece including a tibial surface. The second piece is a femoral piece including a femoral surface. The first piece and the second piece are mutually slidably engagable and separable.
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Smart knee implants may soon be a reality thanks to research conducted by a team including faculty at Binghamton University, State University of New York.
Press Release issued Oct 5, 2017: This report on knee implant market studies the current as well as future prospects of the market globally. The stakeholders of this report include companies and intermediaries engaged in the manufacture and commercialization of various implantable medical devices and products as well as new entrants planning to enter this market.
The Oxford knee replacement is a partial knee implant used to replace the medial side of the knee, explains Zimmer Biomet, the manufacturer of the device. An Oxford knee prosthetic is smaller than a...
JOURNEY II XR Bi-Cruciate Retaining Knee System preserves both the ACL and PCL. JOURNEY II XR is a seamless transition from: JOURNEY II XR (ACL/PCL Retaining) to JOURNEY II CR (PCL Retaining) JOURNEY II BCS (ACL/PCL Sacrificing)