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Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_1 | Pages 4 - 4
1 Feb 2021
Coomer S LaCour M Khasian M Cates H Komistek R
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Introduction

The patella experiences large forces and variable kinematic patterns throughout flexion which could influence function and patient satisfaction after a total knee arthroplasty (TKA). Therefore, the objective of this study is to analyze in vivo patellar mechanism forces and kinematics throughout flexion to determine influencing factors that may lead to patient dissatisfaction.

Methods

Fifty subjects were evaluated in this study, 40 having a Journey II bi-cruciate stabilized (BCS) TKA and 10 having normal, healthy knees. Similar demographics were controlled for each group. Each subject performed a deep knee bend. Kinematics were evaluated using a validated 3D-to-2D fluoroscopic technique while forces were determined using a validated inverse mathematical knee model. A two-tailed t-test was used to evaluate statistical significance.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_1 | Pages 18 - 18
1 Feb 2021
LaCour M Khasian M Jennings J Dennis D Komistek R
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Introduction

Many groups consider passive flexion to be a good indicator of postoperative success, to the point where this outcome directly influences certain outcome scores such as Knee Society Scores (KSS). However, it is alternatively believed that normal-like kinematics result in better TKA outcomes, and previous fluoroscopy studies have demonstrated that there are many parameters that affect weight-bearing range-of-motion. The objective of this study to investigate the correlations between patient-reported outcomes, passive flexion, and weight-bearing knee kinematics.

Methods

The femorotibial kinematics, passive and weight-bearing range-of-motion, and KOOS and KSS for 291 TKA subjects were collected in a retrospective study. The average age, BMI, and post-op time was 69.2±7.2 years, 29.3±4.6, and 22.4±16.3 months, respectively. Pearson correlation analysis was used to find the statistical correlations between the various parameters, and two-tailed t-tests were carried out to find statistical differences.


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_1 | Pages 48 - 48
1 Feb 2021
Khasian M LaCour M Dennis D Komistek R
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Introduction

A common goal of total knee arthroplasty (TKA) is to restore normal knee kinematics. While substantial data is available on TKA kinematics, information regarding non-implanted knee kinematics is less well studied especially in larger patient populations. The objectives of this study were to determine normal femorotibial kinematics in a large number of non-implanted knees and to investigate parameters that yield higher knee flexion with weight-bearing activities.

Methods

Femorotibial kinematics of 104 non-implanted healthy subjects performing a deep knee bend (DKB) activity were analyzed using 3D to 2D fluoroscopy. The average age and BMI were 38.1±18.2 years and 25.2±4.6, respectively. Pearson correlation analysis was used to determine statistical correlations.


Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_1 | Pages 70 - 70
1 Feb 2020
Khasian M LaCour M Dessinger G Meccia B Komistek R
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Introduction

Forward solution joint models (FSMs) can be powerful tools, leading to fast and cost-efficient simulation revealing in vivo mechanics that can be used to predict implant longevity. Unlike most joint analysis methods, mathematical modeling allows for nearly instantaneous evaluations, yielding more rapid surgical technique and implant design iterations as well as earlier insight into the follow-up outcomes used to better assess potential success. The current knee FSM has been developed to analyze both the kinematics and kinetics of commercial TKA designs as well as novel implant designs.

Objective

The objective of this study was to use the knee FSM to predict the condylar translations and axial rotation of both fixed- and mobile-bearing TKA designs during a deep knee bend activity and to compare these kinematics to known fluoroscopy evaluations.


Orthopaedic Proceedings
Vol. 102-B, Issue SUPP_1 | Pages 100 - 100
1 Feb 2020
Khasian M LaCour M Coomer S Komistek R
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Background

Although early TKA designs were symmetrical, during the past two decades TKA have been designed to include asymmetry, pertaining to either the trochlear groove, femoral condylar shapes or the tibial component. More recently, a new TKA was designed to include symmetry in all areas of the design, in the hopes of reducing design and inventory costs.

Objective

The objective of this study was to determine the in vivo kinematics for subjects implanted with this symmetrical TKA during a weight-bearing deep knee bend activity.


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_4 | Pages 80 - 80
1 Apr 2019
Nachtrab J Dessinger G Khasian M LaCour M Sharma A Komistek R
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Introduction

Hip osteoarthritis can be debilitating, often leading to pain, poor kinematics and limiting range of motion. While the in vivo kinematics of a total hip arthroplasty (THA) are well documented, there is limited information pertaining to the kinematics of native, non-arthritic (normal) hips and degenerative hips requiring a THA.

The objective of this study is to evaluate and compare the in vivo kinematics of the normal hip with pre-operative, degenerative hips and post-operative THA.

Methods

Twenty subjects, ten having a normal hip and ten having a pre-operative, degenerative hip that were analyzed before surgery and then post-operatively after receiving a THA. Each subject was asked to perform gait while under mobile fluoroscopic surveillance. Normal and pre-operative degenerative subjects underwent a CT scan so that 3D models of their femur and pelvis could be created. Using 3D-to-2D registration techniques, the hip joint kinematics were derived and assessed.

Femoral head and acetabular cup rotational centers were derived using spheres. The centers of these spheres were used to obtain the femoral head sliding distance on the acetabular cup during the activity. The patient-specific reference femoral head values were obtained from the subjects’ CT scans in a non-weight bearing situation.