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Bone & Joint Research
Vol. 9, Issue 11 | Pages 761 - 767
1 Nov 2020
Hada M Mizu-uchi H Okazaki K Murakami K Kaneko T Higaki H Nakashima Y

Aims

This study aims to investigate the effects of posterior tibial slope (PTS) on knee kinematics involved in the post-cam mechanism in bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) using computer simulation.

Methods

In total, 11 different PTS (0° to 10°) values were simulated to evaluate the effect of PTS on anterior post-cam contact conditions and knee kinematics in BCS TKA during weight-bearing stair climbing (from 86° to 6° of knee flexion). Knee kinematics were expressed as the lowest points of the medial and lateral femoral condyles on the surface of the tibial insert, and the anteroposterior translation of the femoral component relative to the tibial insert.


The Bone & Joint Journal
Vol. 100-B, Issue 12 | Pages 1585 - 1591
1 Dec 2018
Kaneko T Kono N Mochizuki Y Hada M Sunakawa T Ikegami H Musha Y

Aims

Patellofemoral problems are a common complication of total knee arthroplasty. A high compressive force across the patellofemoral joint may affect patient-reported outcome. However, the relationship between patient-reported outcome and the intraoperative patellofemoral contact force has not been investigated. The purpose of this study was to determine whether or not a high intraoperative patellofemoral compressive force affects patient-reported outcome.

Patients and Methods

This prospective study included 42 patients (42 knees) with varus-type osteoarthritis who underwent a bi-cruciate stabilized total knee arthroplasty and in whom the planned alignment was confirmed on 3D CT. Of the 42 patients, 36 were women and six were men. Their mean age was 72.3 years (61 to 87) and their mean body mass index (BMI) was 24.4 kg/m2 (18.2 to 34.3). After implantation of the femoral and tibial components, the compressive force across the patellofemoral joint was measured at 10°, 30°, 60°, 90°, 120°, and 140° of flexion using a load cell (Kyowa Electronic Instruments Co., Ltd., Tokyo, Japan) manufactured in the same shape as the patellar implant. Multiple regression analyses were conducted to investigate the relationship between intraoperative patellofemoral compressive force and patient-reported outcome two years after implantation.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_6 | Pages 52 - 52
1 Mar 2017
Toyoda S Kaneko T Hada M Mochizuki Y Sunakawa T Ikegami H Musha Y
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INTRODUCTION

Patellofemoral compilcations are among the most frequently observed adverse events after total knee arthroplasty. The posterior location with Femoral component of conventional TKA in AP alignment cause paradoxical movement, but, guide motion TKA (Journey.2.BCS) with anterior post-cam remain a correct AP alignment. The purpose of this study was to investigate patellofemoral (PF) contact stress between Bi-Cruciate Substituting TKA (Journey.2.BCS) and CR TKA (Journey.CR).

METHODS

We evaluated 22 knees with medial compartment osteoarthritis who underwent. Simultaneous bilateral TKA. The prospective randomized study was to measure intraoperative PF contact stress by a patellofemoral sensor (Kyowa Co., Ltd., Tokyo, Japan) comparing the identical Bi-Cruciate Substituting or CR Journey.2 total knee prostheses implanted bilaterally in the same patient.


Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_4 | Pages 45 - 45
1 Feb 2017
Kaneko T Hada M Toyoda S Sunakawa T Ikegami H Mochizuki Y Musha Y
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INTRODUCTION

Normal kinematics have not been achieved in TKA design. Recently, knee simulation studies have suggested that a medial pivot TKA can achieve the anatomic pathway that reduce mid-flextion rollback and increase lateral rotation. However, the influence of postoperative flextion angle associated with medial tightness for guide motion TKA remains poorly understood. The purpose of this study was to investigate the effect of postoperative flextion angle and clinical outcomes associated with tightness for medial component gap (MCP).

METHODS

We evaluated 79 patients who underwent 84 medial pivot The Journey.2. Bi-Cruciate Substituting (BCS) TKA using the measured resection tequnique, from June 2014 to March 2016. We measured the gaps after implantation from extension to full flextion with reduced patella by constant distraction force (120N). A new tensor has the same articular shapes as that the tibial liner, including anterior and posterior structure.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_2 | Pages 20 - 20
1 Jan 2016
Hada M Kaneko T Otani T Kono N Mochizuki Y Sunakawa T Ikegami H Musha Y
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A 51 years old female who experienced difficulty in gait ambulation due to secondary osteoarthritis of knee showed knee instability caused by paralysis associated with poliomyelitis and scoliosis. At the first medical examination, right knee range of motion was 0° to 90°, and spino malleolar distance (SMD) showed 72cm for the right leg, 78cm for the left leg, and the bilateral comparison of SMD indicated the leg length discrepancy of 6cm. The patient has a history of surgeries with an anterior – posterior instrument for the treatment of scoliosis, and with Langenskiöld method for the paralyzed right knee at the age of seventeen. The patient also experienced varus degeneration at the age of twenty seven, which was surgically treated with high tibial osteotomy. In this case, a reoperation of her right knee was performed due to the reoccurrence of the knee pain. Preoperative planning was performed using Patient-matched instrument (Signature; Biomet) which was created based on computed tomography data. Each part of osteotomy followed the resection guide by Signature, and a total knee arthroplasty was carried out using the Rotating Hinge Knee System (Zimmer, warsaw. Inc). Two week after the operation, the patient showed the ability to walk without any assistance, and has been in a good condition.