The Experts below are selected from a list of 3609 Experts worldwide ranked by ideXlab platform
Shuichi Matsuda - One of the best experts on this subject based on the ideXlab platform.
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influence of posterior cruciate Ligament Tension on knee kinematics and kinetics
Journal of Knee Surgery, 2016Co-Authors: Muhammad Shoifi Abubakar, Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Shuichi MatsudaAbstract:The posterior cruciate Ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL Tension on knee kinematics and kinetics and to propose an indicator for proper PCL Tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL Tension models. The amount of PCL Tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full exTension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL Tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
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malrotated tibial component increases medial collateral Ligament Tension in tka
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Introduction Malrotation of the tibial component would lead to various complications after total knee arthroplasty (TKA) such as improper joint kinematics, patellofemoral instability, or excessive wear of polyethylene. However, despite reports of internal rotation of the tibial component being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. In this study, we used a musculoskeletal computer model to simulate a squat (0°–130°–0° flexion) and analyzed the effects of malrotated tibial component on lateral and medial collateral Ligament (LCL and MCL) Tensions, tibiofemoral and patellofemoral contact stresses, during the weight-bearing deep knee flexion. Materials and Methods A musculoskeletal model, replicating the dynamic quadriceps-driven weight-bearing knee flexion in previous cadaver studies, was simulated with a posterior cruciate-retaining TKA. The model included tibiofemoral and patellofemoral contact, passive soft tissue and active muscle elements. The soft tissues were modeled as nonlinear springs using previously reported stiffness parameters, and the bony attachments were also scaled to some cadaver reports. The neutral rotational alignment of the femoral and tibial components was aligned according to the femoral epicondylar axis and the tibial anteroposterior axis, respectively. Knee kinematics and Ligament Tensions were computed during a squat for malrotated conditions of the tibial component. The tibial rotational alignments were changed from 15° external rotation to 15° internal rotation in 5° increments. The MCL and LCL Tensions, the tibiofemoral and patellofemoral contact stresses were compared among the knees with different rotational alignment. Results For the MCL, the neutral rotated tibial components caused a maximum Tension of 67.3 N. However, the 15° internally rotated tibial components increased Tensions to 285.2N as a maximum Tension [Fig.1]. By contrast, with external rotation of the tibial component, the MCL Tensions increased only a small amount. The LCL Tension also increased but up to less than half of the MCL value [Fig.2]. The tibiofemoral and patellofemoral contact stresses increased because of a decreased contact area [Fig.3]. Discussion and Conclusion: In this computer simulation, excessive internal rotation in the tibial component increased MCL Tensions and patellofemoral and tibiofemoral contact stresses. The current study suggests that increased MCL Tensions and patellofemoral and tibiofemoral contact stresses caused by a malrotated tibial component could be one cause of patient complaints and polyethylene problems after TKA.
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posterior tibial slope and femoral sizing affect posterior cruciate Ligament Tension in posterior cruciate retaining total knee arthroplasty
Clinical Biomechanics, 2015Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Abstract Background During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased Tension of the posterior cruciate Ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate Ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Methods Forces at the posterior cruciate Ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior–posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Findings Forces at the posterior cruciate Ligament increased by up to 718 N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate Ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate Ligament by up to 41%. In addition, posterior cruciate Ligament Tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. Interpretation These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate Ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate Ligament Tension.
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malrotated tibial component increases medial collateral Ligament Tension in total knee arthroplasty
Journal of Orthopaedic Research, 2014Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shuichi MatsudaAbstract:Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral Ligament (LCL) and medial collateral Ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.
Shinichi Kuriyama - One of the best experts on this subject based on the ideXlab platform.
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effect of tibial component alignment on knee kinematics and Ligament Tension in medial unicompartmental knee arthroplasty
Bone and Joint Research, 2019Co-Authors: Kazuya Sekiguchi, Shinichi Kuriyama, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Kohei Nishitani, Mutsumi Watanabe, Shuicih MatsudaAbstract:Objectives Unicompartmental knee arthroplasty (UKA) is one surgical option for treating symptomatic medial osteoarthritis. Clinical studies have shown the functional benefits of UKA; however, the op...
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influence of posterior cruciate Ligament Tension on knee kinematics and kinetics
Journal of Knee Surgery, 2016Co-Authors: Muhammad Shoifi Abubakar, Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Shuichi MatsudaAbstract:The posterior cruciate Ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL Tension on knee kinematics and kinetics and to propose an indicator for proper PCL Tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL Tension models. The amount of PCL Tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full exTension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL Tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
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malrotated tibial component increases medial collateral Ligament Tension in tka
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Introduction Malrotation of the tibial component would lead to various complications after total knee arthroplasty (TKA) such as improper joint kinematics, patellofemoral instability, or excessive wear of polyethylene. However, despite reports of internal rotation of the tibial component being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. In this study, we used a musculoskeletal computer model to simulate a squat (0°–130°–0° flexion) and analyzed the effects of malrotated tibial component on lateral and medial collateral Ligament (LCL and MCL) Tensions, tibiofemoral and patellofemoral contact stresses, during the weight-bearing deep knee flexion. Materials and Methods A musculoskeletal model, replicating the dynamic quadriceps-driven weight-bearing knee flexion in previous cadaver studies, was simulated with a posterior cruciate-retaining TKA. The model included tibiofemoral and patellofemoral contact, passive soft tissue and active muscle elements. The soft tissues were modeled as nonlinear springs using previously reported stiffness parameters, and the bony attachments were also scaled to some cadaver reports. The neutral rotational alignment of the femoral and tibial components was aligned according to the femoral epicondylar axis and the tibial anteroposterior axis, respectively. Knee kinematics and Ligament Tensions were computed during a squat for malrotated conditions of the tibial component. The tibial rotational alignments were changed from 15° external rotation to 15° internal rotation in 5° increments. The MCL and LCL Tensions, the tibiofemoral and patellofemoral contact stresses were compared among the knees with different rotational alignment. Results For the MCL, the neutral rotated tibial components caused a maximum Tension of 67.3 N. However, the 15° internally rotated tibial components increased Tensions to 285.2N as a maximum Tension [Fig.1]. By contrast, with external rotation of the tibial component, the MCL Tensions increased only a small amount. The LCL Tension also increased but up to less than half of the MCL value [Fig.2]. The tibiofemoral and patellofemoral contact stresses increased because of a decreased contact area [Fig.3]. Discussion and Conclusion: In this computer simulation, excessive internal rotation in the tibial component increased MCL Tensions and patellofemoral and tibiofemoral contact stresses. The current study suggests that increased MCL Tensions and patellofemoral and tibiofemoral contact stresses caused by a malrotated tibial component could be one cause of patient complaints and polyethylene problems after TKA.
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posterior tibial slope and femoral sizing affect posterior cruciate Ligament Tension in posterior cruciate retaining total knee arthroplasty
Clinical Biomechanics, 2015Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Abstract Background During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased Tension of the posterior cruciate Ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate Ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Methods Forces at the posterior cruciate Ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior–posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Findings Forces at the posterior cruciate Ligament increased by up to 718 N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate Ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate Ligament by up to 41%. In addition, posterior cruciate Ligament Tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. Interpretation These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate Ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate Ligament Tension.
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malrotated tibial component increases medial collateral Ligament Tension in total knee arthroplasty
Journal of Orthopaedic Research, 2014Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shuichi MatsudaAbstract:Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral Ligament (LCL) and medial collateral Ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.
Hiromu Ito - One of the best experts on this subject based on the ideXlab platform.
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effect of tibial component alignment on knee kinematics and Ligament Tension in medial unicompartmental knee arthroplasty
Bone and Joint Research, 2019Co-Authors: Kazuya Sekiguchi, Shinichi Kuriyama, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Kohei Nishitani, Mutsumi Watanabe, Shuicih MatsudaAbstract:Objectives Unicompartmental knee arthroplasty (UKA) is one surgical option for treating symptomatic medial osteoarthritis. Clinical studies have shown the functional benefits of UKA; however, the op...
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influence of posterior cruciate Ligament Tension on knee kinematics and kinetics
Journal of Knee Surgery, 2016Co-Authors: Muhammad Shoifi Abubakar, Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Shuichi MatsudaAbstract:The posterior cruciate Ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL Tension on knee kinematics and kinetics and to propose an indicator for proper PCL Tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL Tension models. The amount of PCL Tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full exTension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL Tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
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malrotated tibial component increases medial collateral Ligament Tension in tka
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Introduction Malrotation of the tibial component would lead to various complications after total knee arthroplasty (TKA) such as improper joint kinematics, patellofemoral instability, or excessive wear of polyethylene. However, despite reports of internal rotation of the tibial component being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. In this study, we used a musculoskeletal computer model to simulate a squat (0°–130°–0° flexion) and analyzed the effects of malrotated tibial component on lateral and medial collateral Ligament (LCL and MCL) Tensions, tibiofemoral and patellofemoral contact stresses, during the weight-bearing deep knee flexion. Materials and Methods A musculoskeletal model, replicating the dynamic quadriceps-driven weight-bearing knee flexion in previous cadaver studies, was simulated with a posterior cruciate-retaining TKA. The model included tibiofemoral and patellofemoral contact, passive soft tissue and active muscle elements. The soft tissues were modeled as nonlinear springs using previously reported stiffness parameters, and the bony attachments were also scaled to some cadaver reports. The neutral rotational alignment of the femoral and tibial components was aligned according to the femoral epicondylar axis and the tibial anteroposterior axis, respectively. Knee kinematics and Ligament Tensions were computed during a squat for malrotated conditions of the tibial component. The tibial rotational alignments were changed from 15° external rotation to 15° internal rotation in 5° increments. The MCL and LCL Tensions, the tibiofemoral and patellofemoral contact stresses were compared among the knees with different rotational alignment. Results For the MCL, the neutral rotated tibial components caused a maximum Tension of 67.3 N. However, the 15° internally rotated tibial components increased Tensions to 285.2N as a maximum Tension [Fig.1]. By contrast, with external rotation of the tibial component, the MCL Tensions increased only a small amount. The LCL Tension also increased but up to less than half of the MCL value [Fig.2]. The tibiofemoral and patellofemoral contact stresses increased because of a decreased contact area [Fig.3]. Discussion and Conclusion: In this computer simulation, excessive internal rotation in the tibial component increased MCL Tensions and patellofemoral and tibiofemoral contact stresses. The current study suggests that increased MCL Tensions and patellofemoral and tibiofemoral contact stresses caused by a malrotated tibial component could be one cause of patient complaints and polyethylene problems after TKA.
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posterior tibial slope and femoral sizing affect posterior cruciate Ligament Tension in posterior cruciate retaining total knee arthroplasty
Clinical Biomechanics, 2015Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Abstract Background During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased Tension of the posterior cruciate Ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate Ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Methods Forces at the posterior cruciate Ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior–posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Findings Forces at the posterior cruciate Ligament increased by up to 718 N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate Ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate Ligament by up to 41%. In addition, posterior cruciate Ligament Tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. Interpretation These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate Ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate Ligament Tension.
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malrotated tibial component increases medial collateral Ligament Tension in total knee arthroplasty
Journal of Orthopaedic Research, 2014Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shuichi MatsudaAbstract:Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral Ligament (LCL) and medial collateral Ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.
Moritoshi Furu - One of the best experts on this subject based on the ideXlab platform.
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influence of posterior cruciate Ligament Tension on knee kinematics and kinetics
Journal of Knee Surgery, 2016Co-Authors: Muhammad Shoifi Abubakar, Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Shuichi MatsudaAbstract:The posterior cruciate Ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL Tension on knee kinematics and kinetics and to propose an indicator for proper PCL Tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL Tension models. The amount of PCL Tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full exTension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL Tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
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malrotated tibial component increases medial collateral Ligament Tension in tka
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Introduction Malrotation of the tibial component would lead to various complications after total knee arthroplasty (TKA) such as improper joint kinematics, patellofemoral instability, or excessive wear of polyethylene. However, despite reports of internal rotation of the tibial component being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. In this study, we used a musculoskeletal computer model to simulate a squat (0°–130°–0° flexion) and analyzed the effects of malrotated tibial component on lateral and medial collateral Ligament (LCL and MCL) Tensions, tibiofemoral and patellofemoral contact stresses, during the weight-bearing deep knee flexion. Materials and Methods A musculoskeletal model, replicating the dynamic quadriceps-driven weight-bearing knee flexion in previous cadaver studies, was simulated with a posterior cruciate-retaining TKA. The model included tibiofemoral and patellofemoral contact, passive soft tissue and active muscle elements. The soft tissues were modeled as nonlinear springs using previously reported stiffness parameters, and the bony attachments were also scaled to some cadaver reports. The neutral rotational alignment of the femoral and tibial components was aligned according to the femoral epicondylar axis and the tibial anteroposterior axis, respectively. Knee kinematics and Ligament Tensions were computed during a squat for malrotated conditions of the tibial component. The tibial rotational alignments were changed from 15° external rotation to 15° internal rotation in 5° increments. The MCL and LCL Tensions, the tibiofemoral and patellofemoral contact stresses were compared among the knees with different rotational alignment. Results For the MCL, the neutral rotated tibial components caused a maximum Tension of 67.3 N. However, the 15° internally rotated tibial components increased Tensions to 285.2N as a maximum Tension [Fig.1]. By contrast, with external rotation of the tibial component, the MCL Tensions increased only a small amount. The LCL Tension also increased but up to less than half of the MCL value [Fig.2]. The tibiofemoral and patellofemoral contact stresses increased because of a decreased contact area [Fig.3]. Discussion and Conclusion: In this computer simulation, excessive internal rotation in the tibial component increased MCL Tensions and patellofemoral and tibiofemoral contact stresses. The current study suggests that increased MCL Tensions and patellofemoral and tibiofemoral contact stresses caused by a malrotated tibial component could be one cause of patient complaints and polyethylene problems after TKA.
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posterior tibial slope and femoral sizing affect posterior cruciate Ligament Tension in posterior cruciate retaining total knee arthroplasty
Clinical Biomechanics, 2015Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Abstract Background During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased Tension of the posterior cruciate Ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate Ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Methods Forces at the posterior cruciate Ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior–posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Findings Forces at the posterior cruciate Ligament increased by up to 718 N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate Ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate Ligament by up to 41%. In addition, posterior cruciate Ligament Tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. Interpretation These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate Ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate Ligament Tension.
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malrotated tibial component increases medial collateral Ligament Tension in total knee arthroplasty
Journal of Orthopaedic Research, 2014Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shuichi MatsudaAbstract:Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral Ligament (LCL) and medial collateral Ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.
Masahiro Ishikawa - One of the best experts on this subject based on the ideXlab platform.
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influence of posterior cruciate Ligament Tension on knee kinematics and kinetics
Journal of Knee Surgery, 2016Co-Authors: Muhammad Shoifi Abubakar, Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Yoshihisa Tanaka, Shuichi MatsudaAbstract:The posterior cruciate Ligament (PCL) has an important role in cruciate-retaining total knee arthroplasty to achieve good clinical results. The purpose of the study was to examine the influence of PCL Tension on knee kinematics and kinetics and to propose an indicator for proper PCL Tension during surgery. A squatting activity was simulated in a weight-bearing deep knee bend using a musculoskeletal computer simulation knee model. The length of the PCL was changed to represent different PCL Tension models. The amount of PCL Tension significantly influenced knee kinematics and kinetics. In the normal PCL model, the facet center positions at 90 degrees of knee flexion were positioned at almost the same position as in full exTension. A loose PCL-induced paradoxical anterior movement and greater patellofemoral forces, whereas a tight PCL was related to excessive rollback and increased tibiofemoral forces. This study suggested ideal knee kinematics with proper PCL Tension, in which the medial contact position at full flexion was almost similar to the position at 90 degrees of knee flexion.
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malrotated tibial component increases medial collateral Ligament Tension in tka
Journal of Bone and Joint Surgery-british Volume, 2016Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Introduction Malrotation of the tibial component would lead to various complications after total knee arthroplasty (TKA) such as improper joint kinematics, patellofemoral instability, or excessive wear of polyethylene. However, despite reports of internal rotation of the tibial component being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. In this study, we used a musculoskeletal computer model to simulate a squat (0°–130°–0° flexion) and analyzed the effects of malrotated tibial component on lateral and medial collateral Ligament (LCL and MCL) Tensions, tibiofemoral and patellofemoral contact stresses, during the weight-bearing deep knee flexion. Materials and Methods A musculoskeletal model, replicating the dynamic quadriceps-driven weight-bearing knee flexion in previous cadaver studies, was simulated with a posterior cruciate-retaining TKA. The model included tibiofemoral and patellofemoral contact, passive soft tissue and active muscle elements. The soft tissues were modeled as nonlinear springs using previously reported stiffness parameters, and the bony attachments were also scaled to some cadaver reports. The neutral rotational alignment of the femoral and tibial components was aligned according to the femoral epicondylar axis and the tibial anteroposterior axis, respectively. Knee kinematics and Ligament Tensions were computed during a squat for malrotated conditions of the tibial component. The tibial rotational alignments were changed from 15° external rotation to 15° internal rotation in 5° increments. The MCL and LCL Tensions, the tibiofemoral and patellofemoral contact stresses were compared among the knees with different rotational alignment. Results For the MCL, the neutral rotated tibial components caused a maximum Tension of 67.3 N. However, the 15° internally rotated tibial components increased Tensions to 285.2N as a maximum Tension [Fig.1]. By contrast, with external rotation of the tibial component, the MCL Tensions increased only a small amount. The LCL Tension also increased but up to less than half of the MCL value [Fig.2]. The tibiofemoral and patellofemoral contact stresses increased because of a decreased contact area [Fig.3]. Discussion and Conclusion: In this computer simulation, excessive internal rotation in the tibial component increased MCL Tensions and patellofemoral and tibiofemoral contact stresses. The current study suggests that increased MCL Tensions and patellofemoral and tibiofemoral contact stresses caused by a malrotated tibial component could be one cause of patient complaints and polyethylene problems after TKA.
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posterior tibial slope and femoral sizing affect posterior cruciate Ligament Tension in posterior cruciate retaining total knee arthroplasty
Clinical Biomechanics, 2015Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shinichiro Nakamura, Shuichi MatsudaAbstract:Abstract Background During cruciate-retaining total knee arthroplasty, surgeons sometimes encounter increased Tension of the posterior cruciate Ligament. This study investigated the effects of femoral size, posterior tibial slope, and rotational alignment of the femoral and tibial components on forces at the posterior cruciate Ligament in cruciate-retaining total knee arthroplasty using a musculoskeletal computer simulation. Methods Forces at the posterior cruciate Ligament were assessed with the standard femoral component, as well as with 2-mm upsizing and 2-mm downsizing in the anterior–posterior dimension. These forces were also determined with posterior tibial slope angles of 5°, 7°, and 9°, and lastly, were measured in 5° increments when the femoral (tibial) components were positioned from 5° (15°) of internal rotation to 5° (15°) of external rotation. Findings Forces at the posterior cruciate Ligament increased by up to 718 N with the standard procedure during squatting. The 2-mm downsizing of the femoral component decreased the force at the posterior cruciate Ligament by up to 47%. The 2° increment in posterior tibial slope decreased the force at the posterior cruciate Ligament by up to 41%. In addition, posterior cruciate Ligament Tension increased by 11% during internal rotation of the femoral component, and increased by 18% during external rotation of the tibial component. Interpretation These findings suggest that accurate sizing and bone preparation are very important to maintain posterior cruciate Ligament forces in cruciate-retaining total knee arthroplasty. Care should also be taken regarding malrotation of the femoral and tibial components because this increases posterior cruciate Ligament Tension.
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malrotated tibial component increases medial collateral Ligament Tension in total knee arthroplasty
Journal of Orthopaedic Research, 2014Co-Authors: Shinichi Kuriyama, Masahiro Ishikawa, Moritoshi Furu, Hiromu Ito, Shuichi MatsudaAbstract:Malrotation of the tibial component can lead to complications after total knee arthroplasty (TKA). Despite reports of internal rotation being associated with more severe pain or stiffness than external rotation, the biomechanical reasons remain largely unknown. We used a computer simulation model and evaluated traction forces in the lateral collateral Ligament (LCL) and medial collateral Ligament (MCL) with a malrotated tibial component during squatting. We also examined tibiofemoral and patellofemoral contact forces and stresses under similar conditions. A dynamic musculoskeletal knee model was simulated in three different constrained tibial geometries with a prototype component. The testing conditions were changed between 15° external and 15° internal rotation of the tibial component. With internal rotation of the tibial component, the MCL force increased progressively; the LCL force also increased, but only up to less than half of the MCL force values. A higher degree of constraint of the tibial component was associated with greater femoral rotational movement and higher MCL forces. The tibiofemoral and patellofemoral contact forces were not influenced by malrotation of the tibial component, but the contact stresses increased because of decreased contact area. This altered loading condition could cause patient complaints and polyethylene problems after TKA.