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Ryosuke Kuroda - One of the best experts on this subject based on the ideXlab platform.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    2018
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA.Materials and MethodsTwenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after tri...

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    2018
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA.Materials and MethodsSixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene t...

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA. Materials and Methods Sixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal and sagittal relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) in the navigation system. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with a ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results Joint gap assessment revealed significant enlargement in both of extension and 90 degrees in flexion after PCL resection compared with before resection. In kinematic analyses in navigation system, regarding to amount of sagittal movement of tibia, there were significances between before and after PCL resection in 60 and 90 degrees in flexion, 1.2mm difference in 60 degrees, and 2.3mm difference in 90 degrees in flexion. There were no significance between before and after PCL resection in the other degrees in flexion. Regarding to the other analyses, varus/ valgus and rotation, there were no differences between before and after resection of PCL. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    Journal of Bone and Joint Surgery-british Volume, 2016
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA. Materials and Methods Twenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal (valgus/varus), sagittal (anterior/posterior) and rotational relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) (Figure1). During record of kinematics, the surgeon gently lifted the experimental thigh three times, flexing the hip and knee. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with paired t-test, and an ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results In coronal (valgus/varus) movement, there are no difference between before and after resection of PCL in all ROM. Regarding to amount of sagittal movement of tibia, tibia was slightly shifted approximately 0.75mm posteriorly in 60 degrees of flexion (p=0.013). There are no significance between before and after PCL resection in the other ROM. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. This study was localized at point of certain situation that difference between extension and flexion gap is under 3mm after bony cut of femur and tibia during surgery. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.

  • In Vivo Kinematic Analyses of Three Different Designs of Polyethylene Inserts During Total Knee Arthroplasty (TKA) - Cruciate-Substituting (CS) Polyethylene Insert May Function as Expected
    Journal of Bone and Joint Surgery-british Volume, 2013
    Co-Authors: Katsumasa Tei, Tomoyuki Matsumoto, Masahiro Kurosaka, Nao Shibanuma, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized Polyethylene Insert, even if posterior cruciate ligament (PCL) is sacrificed after total knee arthroplasty (TKA). The purpose of this study is an investigation of in vivo kinematics of three different tibial Insert designs using computer assisted navigation system intra-operatively in TKA. Materials and Methods Sixty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker, New Jersey, USA) were performed using computer assisted navigation system. During surgery, three different designs of Polyethylene tibial trial Inserts (PS, CS, and cruciate-retaining (CR) Polyethylene Insert) were Inserted respectively after implantation of femoral and tibial components. The kinematic parameters of the soft-tissue balance were obtained by interpreting kinematics curve, which display bicompartmental gaps throughout the range of motion (ROM) after implantation of each trial Insert (Figure. 1). During record of kinematics, the surgeon gently lifted the experimental thigh three times, flexing the hip and knee. Deviation of these three values in each ROM was calculated in each tibial Insert in each patient for descriptive analysis. Results Regarding to values of compartmental gaps, there are no significance between three Inserts in both medial and lateral compartments (Figure 2a, b). On medial compartmental gaps, the values of deviations were significantly higher in CR Insert than both of PS and CS Insert in ROM of over 45 degrees in extension (Fig 3a). In addition, concerning lateral compartmental gaps, the values of deviations were significantly higher in CS Insert than both PS and CS Insert in all ROM (Fig 3b). Furthermore, there was no significance between PS and CS Insert in overall range of motion in both medial and lateral compartmental gaps (Fig 3a, b). Discussion These results demonstrated that CS Polyethylene Insert has a stability of femoro-tibial joint nearly as well as PS Polyethylene Insert. While PS Insert may leads to surface damage on open box and has necessity of cutting more bone of femur, some problems involving management of PCL are enumerated in CR Inserts. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. Due to the design features and benefits, there is a high possibility that CS Insert can lead same ROM as PS Insert, although PS design can produce more ROM than the other type of Insert type. Based on these backgrounds, it is suggested that CS Insert may have an additional choice in TKA with some advantages especially in concerning of high activity patients like middle aged patients.

Katsumasa Tei - One of the best experts on this subject based on the ideXlab platform.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    2018
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA.Materials and MethodsTwenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after tri...

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    2018
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA.Materials and MethodsSixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene t...

  • Post-cam clunk syndrome after posterior stabilized total knee arthroplasty as a sign of early femoral component loosening
    Elsevier, 2018
    Co-Authors: Akihiko Toda, Katsumasa Tei, Tomoyuki Matsumoto, Nao Shibanuma, Kazunari Ishida, Hiroshi Sasaki, Kazuki Kodato, Yuichiro Nishizawa, Shinsuke Kirizuki, Hiroomi Tateishi
    Abstract:

    Soft tissue impingements are well-known complications of total knee arthroplasty. The impingements usually occur between the medial or lateral femoral component and tibial Insert, and between the patella and femoral components. We report a rare case of impingement of the soft tissue between the femoral intercondylar fossa and post of the Polyethylene Insert, which caused pain and walking disability. After the surgery for the arthroscopic removal of the soft tissue, the symptoms disappeared. However, prosthetic loosening of the femur occurred several months after the arthroscopic surgery, requiring revision surgery. We would propose to call this symptom as post-cam clunk syndrome

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA. Materials and Methods Sixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal and sagittal relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) in the navigation system. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with a ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results Joint gap assessment revealed significant enlargement in both of extension and 90 degrees in flexion after PCL resection compared with before resection. In kinematic analyses in navigation system, regarding to amount of sagittal movement of tibia, there were significances between before and after PCL resection in 60 and 90 degrees in flexion, 1.2mm difference in 60 degrees, and 2.3mm difference in 90 degrees in flexion. There were no significance between before and after PCL resection in the other degrees in flexion. Regarding to the other analyses, varus/ valgus and rotation, there were no differences between before and after resection of PCL. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    Journal of Bone and Joint Surgery-british Volume, 2016
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA. Materials and Methods Twenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal (valgus/varus), sagittal (anterior/posterior) and rotational relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) (Figure1). During record of kinematics, the surgeon gently lifted the experimental thigh three times, flexing the hip and knee. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with paired t-test, and an ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results In coronal (valgus/varus) movement, there are no difference between before and after resection of PCL in all ROM. Regarding to amount of sagittal movement of tibia, tibia was slightly shifted approximately 0.75mm posteriorly in 60 degrees of flexion (p=0.013). There are no significance between before and after PCL resection in the other ROM. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. This study was localized at point of certain situation that difference between extension and flexion gap is under 3mm after bony cut of femur and tibia during surgery. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.

William J. Hozack - One of the best experts on this subject based on the ideXlab platform.

Gregg R Klein - One of the best experts on this subject based on the ideXlab platform.

  • Corrosion Damage and Wear Mechanisms in Long-Term Retrieved CoCr Femoral Components for Total Knee Arthroplasty
    Journal of Arthroplasty, 2016
    Co-Authors: Christina M Arnholt, Sevi B. Kocagoz, Arthur L. Malkani, Daniel W. Macdonald, Gregg R Klein, Clare M. Rimnac, Steven M Kurtz, Jeremy L. Gilbert
    Abstract:

    Background Metal debris and ion release has raised concerns in joint arthroplasty. The purpose of this study was to characterize the sources of metallic ions and particulate debris released from long-term (in vivo >15 years) total knee arthroplasty femoral components. Methods A total of 52 CoCr femoral condyles were identified as having been implanted for more than 15 years. The femoral components were examined for incidence of 5 types of damage (metal-on-metal wear due to historical Polyethylene Insert failure, mechanically assisted crevice corrosion at taper interfaces, cement interface corrosion, third-body abrasive wear, and inflammatory cell–induced corrosion [ICIC]). Third-body abrasive wear was evaluated using the Hood method for Polyethylene components and a similar method quantifying surface damage of the femoral condyle was used. The total area damaged by ICIC was quantified using digital photogrammetry. Results Surface damage associated with corrosion and/or CoCr debris release was identified in 51 (98%) CoCr femoral components. Five types of damage were identified: 98% of femoral components exhibited third-body abrasive wear (mostly observed as scratching, n = 51/52), 29% of femoral components exhibited ICIC damage (n = 15/52), 41% exhibited cement interface damage (n = 11/27), 17% exhibited metal-on-metal wear after wear-through of the Polyethylene Insert (n = 9/52), and 50% of the modular femoral components exhibited mechanically assisted crevice corrosion taper damage (n = 2/4). The total ICIC-damaged area was an average of 0.11 ± 0.12 mm2 (range: 0.01-0.46 mm2). Conclusion Although implant damage in total knee arthroplasty is typically reported with regard to the Polyethylene Insert, the results of this study demonstrate that abrasive and corrosive damage occurs on the CoCr femoral condyle in vivo.

  • the effect of tibial Polyethylene Insert design on range of motion evaluation of in vivo knee kinematics by a computerized navigation system during total knee arthroplasty
    Journal of Arthroplasty, 2004
    Co-Authors: Gregg R Klein, Javad Parvizi, Venkat R. Rapuri, Mathew S. Austin, William J. Hozack
    Abstract:

    Computer-assisted navigation for total knee arthroplasty offers the unique opportunity to assess in vivo knee kinematics during surgery and implement changes whenever appropriate. Using a computerized navigation system, the effect of 2 tibial Polyethylene Insert designs on knee kinematics in general and knee range of motion (ROM) in particular was evaluated in 37 knee arthroplasties in 30 patients. The Scorpioflex tibial Insert was found to provide a significant increase in mean extension, mean flexion, and overall ROM of the knee compared with the standard tibial Insert (P<.005) without affecting knee ligamentous balance. Navigation is a very effective and useful tool for intraoperative assessment of knee kinematics and accurate recording of ROM. Based on the information obtained from the navigation software, the surgeon can implement changes in selection of the knee components with beneficial effects in knee kinematics in general and knee ROM in particular. This may, in turn, translate to better clinical outcome of the knee arthroplasty.

  • The effect of tibial Polyethylene Insert design on range of motion: evaluation of in vivo knee kinematics by a computerized navigation system during total knee arthroplasty.
    The Journal of arthroplasty, 2004
    Co-Authors: Gregg R Klein, Javad Parvizi, Venkat R. Rapuri, Mathew S. Austin, William J. Hozack
    Abstract:

    Computer-assisted navigation for total knee arthroplasty offers the unique opportunity to assess in vivo knee kinematics during surgery and implement changes whenever appropriate. Using a computerized navigation system, the effect of 2 tibial Polyethylene Insert designs on knee kinematics in general and knee range of motion (ROM) in particular was evaluated in 37 knee arthroplasties in 30 patients. The Scorpioflex tibial Insert was found to provide a significant increase in mean extension, mean flexion, and overall ROM of the knee compared with the standard tibial Insert (P

Tomoyuki Matsumoto - One of the best experts on this subject based on the ideXlab platform.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    2018
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA.Materials and MethodsTwenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after tri...

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    2018
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    IntroductionRecently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA.Materials and MethodsSixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene t...

  • Post-cam clunk syndrome after posterior stabilized total knee arthroplasty as a sign of early femoral component loosening
    Elsevier, 2018
    Co-Authors: Akihiko Toda, Katsumasa Tei, Tomoyuki Matsumoto, Nao Shibanuma, Kazunari Ishida, Hiroshi Sasaki, Kazuki Kodato, Yuichiro Nishizawa, Shinsuke Kirizuki, Hiroomi Tateishi
    Abstract:

    Soft tissue impingements are well-known complications of total knee arthroplasty. The impingements usually occur between the medial or lateral femoral component and tibial Insert, and between the patella and femoral components. We report a rare case of impingement of the soft tissue between the femoral intercondylar fossa and post of the Polyethylene Insert, which caused pain and walking disability. After the surgery for the arthroscopic removal of the soft tissue, the symptoms disappeared. However, prosthetic loosening of the femur occurred several months after the arthroscopic surgery, requiring revision surgery. We would propose to call this symptom as post-cam clunk syndrome

  • INTRA-OPERATIVE STABILITY ANALYSES WITH USE OF NAVIGATION SYSTEM AND TENSOR DEVICE BEFORE/ AFTER PCL RESECTION IN TKA USING CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert
    Journal of Bone and Joint Surgery-british Volume, 2017
    Co-Authors: Katsumasa Tei, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Masaya Minoda, S. Matsuda, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed and widely used. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femoro-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femoro-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system and tensor device intra-operatively in TKA. Materials and Methods Sixty-one consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. During surgery, using a tensor device, after bony cut of femur and tibia, joint gaps were assessed in 0 and 90 degrees in flexion. Then, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal and sagittal relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) in the navigation system. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with a ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results Joint gap assessment revealed significant enlargement in both of extension and 90 degrees in flexion after PCL resection compared with before resection. In kinematic analyses in navigation system, regarding to amount of sagittal movement of tibia, there were significances between before and after PCL resection in 60 and 90 degrees in flexion, 1.2mm difference in 60 degrees, and 2.3mm difference in 90 degrees in flexion. There were no significance between before and after PCL resection in the other degrees in flexion. Regarding to the other analyses, varus/ valgus and rotation, there were no differences between before and after resection of PCL. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.

  • CRUCIATE-SUBSTITUTING (CS) Polyethylene Insert MAY LEAD POSTERIOR STABILISATION WITHOUT POSTERIOR CRUCIATE LIGAMENT AS EXPECTED IN TKA: INTRA-OPERATIVE KINEMATIC ANALYSES
    Journal of Bone and Joint Surgery-british Volume, 2016
    Co-Authors: Katsumasa Tei, Shinsuke Kihara, T. Shimizu, Tomoyuki Matsumoto, Masahiro Kurosaka, Ryosuke Kuroda
    Abstract:

    Introduction Recently, tibial Insert design of cruciate-substituting (CS) Polyethylene Insert is employed. However, in vivo kinematics of using CS Polyethylene Insert is still unclear. In this study, it is hypothesized that CS Polyethylene Insert leads to stability of femolo-tibial joint as well as posterior-stabilized (PS) Polyethylene Insert, even if PCL is sacrificed after TKA. The purpose of this study is an investigation of in vivo kinematics of femolo-tibial joint with use of CS Polyethylene Insert before and after PCL resction using computer assisted navigation system intra-operatively in TKA. Materials and Methods Twenty-four consecutive patients who had knees of osteoarthritis with varus deformity were investigated in this study. All TKAs (Triathlon, Stryker) were performed using computer assisted navigation system. In all patients, difference between extension and flexion gap was under 3mm after bony cut of femur and tibia. During surgery, CS Polyethylene tibial trial Insert were Inserted after trial implantation of femoral and tibial components, before and after resection of PCL, respectively. The kinematic parameters of the soft-tissue balance, and amount of coronal (valgus/varus), sagittal (anterior/posterior) and rotational relative movement between femur and tibia were obtained by interpreting kinematics, which display tables throughout the range of motion (ROM) (Figure1). During record of kinematics, the surgeon gently lifted the experimental thigh three times, flexing the hip and knee. In each ROM (30, 45, 60, 90, max degrees), the data were analyzed with paired t-test, and an ANOVA test, and mean values were compared by the multiple comparison test (Turkey HSD test) (p Results In coronal (valgus/varus) movement, there are no difference between before and after resection of PCL in all ROM. Regarding to amount of sagittal movement of tibia, tibia was slightly shifted approximately 0.75mm posteriorly in 60 degrees of flexion (p=0.013). There are no significance between before and after PCL resection in the other ROM. In addition, concerning ROM, maximum extension angle is significantly lower, and maximum flexion angle is significantly higher after than before PCL resection. Discussion These results demonstrated that CS Polyethylene Insert might have a stability of femoro-tibial joint nearly after PCL resection as well as before PCL resection. The main design feature of Triathlon CS Insert is single radius and rotary arc, in addition, the posterior lip is same as that of Triathlon CR, which can be the factor to avoid paradoxical anterior movement and to permit internal and external rotation between femoral and tibial component. This study was localized at point of certain situation that difference between extension and flexion gap is under 3mm after bony cut of femur and tibia during surgery. Due to the design features and benefits, there is a high possibility that use of CS Insert without PCL can lead same stability as PCL remained, and improvement of ROM. Based on these backgrounds, it is suggested that CS Insert may have an additional choice of PCL resection in case of tight gap of flexion in TKA.