Briard Jl. Are All Mb Knees The Same. Slide 1 28
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The document discusses key design aspects of mobile bearing knees that impact stability, motion, and wear. Maximum conformity can be achieved through multi-radius or constant radius femoral designs. Motion of the bearing relative to the tibial tray can be uni-directional or multi-directional, with the latter posing higher wear risks. Stability also depends on jump height, post-cam engagement, and surgical technique. While mobile bearing knees aim to reduce wear, their mechanisms may fail over time and not all designs provide equal longevity.
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The document discusses deformities of the knee and their correction during total knee arthroplasty. For genu varum, which is primarily a tibial deformity, correcting the tibial joint line from oblique to perpendicular with a medial release is sufficient. For genu valgum femur, the femoral joint line needs to be reoriented from oblique to horizontal through lateral release and compensating for bone missing from the lateral condyle by adjusting the femoral component rotation. Flexion gap can be maintained by releasing the medial collateral ligament and elongating it.
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This document discusses lateral knee instability issues that can arise from weak or loose lateral structures after a knee replacement. It notes the danger of subsequent medial instability if too much of the medial plateau is resected. For knees with elongated and weak lateral structures, it recommends using the transepicondylar line as a guide and a constrained implant design for small deformities. Alternatively, a lateral condyle osteotomy could be considered. It also discusses various tibial and femoral osteotomy techniques for addressing leg alignment issues greater than 8-10 degrees. Femoral deformity corrections are noted to be more difficult due to their influence on both extension and flexion gaps.
Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
To correct deformities outside the knee joint without causing instability during a total knee replacement, the surgeon must consider both the shape of the bones and the proper alignment of the mechanical axis. The knee should be stabilized in a neutral horizontal or perpendicular joint line by aligning the prosthetic femur and tibia normally. This can be achieved by adjusting the resection of the medial femoral condyle or lateral tibial plateau to create an horizontal joint line in extension.
Briard Jl. How To Correct Extra Articular Deformity. Slide 15 26
The document discusses surgical techniques for dealing with extra-articular deformities in total knee arthroplasty (TKA). It notes that lateral collateral ligament release for femoral varum is difficult and risks postoperative instability, while medial release is safer. It recommends intra-articular correction of extra-articular deformity over extra-articular procedures. For femoral varum, it suggests medial release, lateral condyle resection, femoral rotation in internal rotation, or a medial condylar osteotomy. For tibial valgum, it recommends a lateral collateral ligament release.
Correcting Varus Deformity of the Knee in Total Knee Replacement
This document discusses the varus knee, including:
1. Classification of varus knee deformities into intraarticular, metaphyseal, extraarticular, and PAGODA deformity.
2. The sequential approach to correction involves assessing and classifying the deformity, performing a medial release through multiple structures, osteophyte removal, and bone realignment through techniques like shift and resect or pie crusting if needed.
3. Key steps are creating a medial sleeve through layered release of the MCL and other medial structures, complete removal of osteophytes that can impede correction, and balancing flexion and extension gaps.
Johnson Dp. Mis Knee Replacement. What Are The Functional Benefits. Slide 1 18
MIS knee replacement can provide functional benefits such as faster rehabilitation, shorter hospital stays, and improved range of motion compared to traditional knee replacement. However, MIS knee replacement also has risks such as inferior component placement and revision surgery that may be higher in the initial learning curve as the surgeon gains experience with the technique. The benefits of MIS must be weighed against the potential risks.
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 1 39
The document discusses the role of computer assisted surgery (CAS) in orthopedics. It notes that CAS aims to improve implant longevity, reduce human error, and simplify surgical techniques. While CAS can increase accuracy, early systems were too troublesome with complex feedback and safety systems. The document examines studies on the benefits of CAS for total knee arthroplasty, finding it can reduce outliers but does not clearly provide better patient outcomes. Large sample sizes are still needed to detect small differences. Accuracy depends on multiple factors introducing errors. While CAS aims to benefit patients, early techniques also increased costs and surgery time. [/SUMMARY]
Anatomy Lect 8 Le
The document provides an overview of anatomy related to the lower extremities, including the pelvis, hips, femur, knee, lower leg, ankle and foot. Key points covered include common injuries such as hip dislocations, femur fractures, iliotibial band friction syndrome, hamstring injuries and knee ligament sprains. Examinations signs and treatments for various conditions are also discussed.
Knee biomechanics dr.bhuvanesh
This document discusses knee biomechanics and provides definitions of key concepts. It summarizes the biomechanics of the knee joint, including range of motion, meniscus function, ligament function, and alignment. Key points are that the knee is a hinge joint with rolling and sliding motion. The menisci absorb shock, distribute load, and aid lubrication. The ACL and PCL prevent unwanted translation of the tibia. Proper lower extremity alignment and the Q-angle are important for knee function.
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Briard Jl. How To Correct Extra Articular Deformity. Slide 41 56
Briard Jl. How To Correct Extra Articular Deformity. Slide 41 56
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 47 55
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 47 55
Johnson Dp. Mis Knee Replacement. What Are The Functional Benefits. Slide 19 36
Johnson Dp. Mis Knee Replacement. What Are The Functional Benefits. Slide 19 36
Beverland D. Cemented Or Non Cemented Fixation, An Issue
Beverland D. Cemented Or Non Cemented Fixation, An Issue
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 47 55
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 47 55
Hamelynck Kj. Stability Of The Knee, A Dynamic Concept
Hamelynck Kj. Stability Of The Knee, A Dynamic Concept
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 40 44
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 40 44
Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14
Briard Jl. How To Correct Extra Articular Deformity. Slide 7 14
Briard Jl. How To Correct Extra Articular Deformity. Slide 27 40
Briard Jl. How To Correct Extra Articular Deformity. Slide 27 40
Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
Briard Jl. How To Correct Extra Articular Deformity. Slide 15 26
Briard Jl. How To Correct Extra Articular Deformity. Slide 15 26
Correcting Varus Deformity of the Knee in Total Knee Replacement
Correcting Varus Deformity of the Knee in Total Knee Replacement
Johnson Dp. Mis Knee Replacement. What Are The Functional Benefits. Slide 1 18
Johnson Dp. Mis Knee Replacement. What Are The Functional Benefits. Slide 1 18
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 1 39
SøRen Toksvig Larsen. The Role Of Cas (Computer Assisted Surgery). Slide 1 39
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Kambis Mashayekhi: Microcatheter selection and manipulation- How to make the ...
14th Experts Live CTO
September 2nd - 3rd, 2022 - Mainz, Germany
Main Session - Lunch Symposium by Asahi:
Road to CTO expert 2022 – how to build your CTO toolkit
Microcatheter selection and manipulation- How to make the right choice
Kambis Mashayekhi, Lahr, Germany
Room:
Guteberg Hall (Auditorium) - Saturday 13:30
Speaker:
Gerald Werner, Darmstadt, Germany;
Kambis Mashayekhi, Lahr, Germany;
Jo Dens, Genk, Belgium;
Gregor Leibundgut, Bâle, Suisse
biomechanics of far cortex locking
need for far cortex locking - journal presentation.
motion loc - zimmer, dynamic locking screw (DLS) - SYNTHES.
Osteotomy
Incision or transection of bone.
Uses:-
to correct deformity.
to change shape of bone.
to redirect load trajectories in a limb so as to influence joint function.
Basics of Orthosis & Prosthesis.pptx
This document provides an overview of orthosis and prosthesis. It begins with introducing orthosis, discussing their functions, biomechanics, classifications, and examples of common lower and upper limb orthoses. It then introduces prosthesis, discussing the components and types of lower limb prosthesis, including different sockets, suspension methods, knee and terminal devices. Examples of both immediate post-op and long-term lower and upper limb prosthetic options are outlined.
Beamand slab design
- A beam-and-slab system uses a one-way slab supported by beams cast compositely with the slab, forming an efficient floor system.
- The slab is designed as a continuous slab using continuous beam theory or a simplified coefficient method. Beams act as L-beams on edges and T-beams interiorly.
- T-beams and L-beams save weight while providing a greater lever arm for strength and stiffness over conventional beams. Ensuring the beam and slab are securely connected requires consideration of vertical and horizontal shear forces.
Beam and slab design
- A beam-and-slab system uses a one-way slab supported by beams cast compositely with the slab, forming an efficient floor system.
- The slab is designed as a continuous slab using continuous beam theory or a simplified coefficient method. Beams act as L-beams on edges and T-beams interiorly.
- T-beams and L-beams save weight while providing a greater lever arm for strength and stiffness over conventional beams. Ensuring the beam and slab are securely connected requires attention to vertical and horizontal shear forces.
Presentation on POT Bearing for Bridges and others Structure..pptx
Bearing is a component of a bridge which typically locates between bridge substructures and superstructures, playing an important role in the force transmission and in accommodating the deformation caused by temperature variation and the earthquake.
This PPT is covering these all data, type of bearing, test as per ITP and acceptance criteria
Compression_members1.ppt
1) The document discusses the design of compression members and buckling behavior. It covers topics like Euler buckling analysis, factors that affect column strength, and modern design using column curves.
2) Key aspects reviewed include elastic buckling of pin-ended columns, the influence of imperfections and eccentric loading on column strength, and classification of sections based on their buckling behavior.
3) Design approaches like effective length, slenderness ratio, and determining the design compressive stress are summarized. Both elastic and inelastic buckling modes are addressed.
C0541925
IOSR Journal of Mechanical and Civil Engineering (IOSR-JMCE) is an open access international journal that provides rapid publication (within a month) of articles in all areas of mechanical and civil engineering and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications in mechanical and civil engineering. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
DESIGN OF STEEL COLUMN.pptx
This document provides a summary of steel columns, including:
1. It defines steel columns and their key characteristics such as shape, load bearing capacity, and connections.
2. It classifies columns based on cross-sectional shape, loading type, reinforcement, and slenderness ratio.
3. It discusses effective length, slenderness ratio, column bases, and provides examples of calculating load capacity.
Rolamentos Lineares SKF
The document discusses SKF's factory pre-lubrication standard for linear bearings and units. SKF now offers pre-lubricated linear bearings as a standard that are greased in the factory, saving assembly time and improving reliability. Most SKF linear ball bearings and units with shaft diameters of 6mm or greater are pre-lubricated by default with SKF grease LGEP2. The document also provides an overview of SKF's linear ball bearing, plain bearing, and unit product lines.
Pier & bridge guide
This document provides details on the design of multi-level station piers for elevated metro corridors. It describes the main components of the station pier, including the main pier, pier above the concourse arm, and pier above the pier cap. It discusses the forces acting on the piers, including axial, shear, moment, and torsion forces. It also provides details on the geometric dimensions, cable profiling, reinforcement, and design considerations for the piers.
Reverse shoulder biomechanics
1) Reverse shoulder arthroplasty designs impact joint biomechanics by altering the deltoid moment arm and tension through variations in glenosphere medialization/lateralization and humeral component design.
2) Medializing the glenosphere increases the deltoid moment arm but can increase scapular notching and instability risks, while lateralizing the glenosphere reduces these risks but decreases deltoid efficiency.
3) Lateralizing the humeral component improves deltoid wrapping and compression at the joint while maintaining deltoid efficiency compared to more medial designs.
Cervical Disc Replacement in Orthopaedics
Cervical Disc Replacement, Cervical Disc Arthroplasty, Adjacent Segment Disease, Recent Advances, Discusses about the cervical disc replacement or arhroplasty for cervical spine disease
requires certain indication such as level from c3-c7, single or maximum 2 level, Mechanical loading of disc cause of degeneration
Treatment: Conservative magment to surgery +/- fusion
fusion associated with ASD, pseudoarthrosis, donor site mobility, restricted motion, altered physiology Depends on implant based parameters:
wear
material
kinetics
Depends on Patient based parameters:
Age, Sex, gender
Weight, BMI
Depends on Surgeon based parametes:
Precision, skill
soft tissue and bone handling
single-level,
myelopathic, or radiculopathic cervical disease
between C3 and C7
All of above in symptomatic patient
failing 6 weeks of conservative management
Osteoporosis
Significant kyphosis
Instability, greater than 50% loss of disc height
Facet arthropathy
Ossification of PLL
Inflammatory arthropathy
Multilevel disease
Translation > 3.5 mm on flexion extension X-rays
ACDF with CDR:
for multilevel cervical Degen Disc Disease(DDD)
Combination of fusion and nonfusion tailored to each level
allowing segmental motion preservation at index levels
minimizing hypermobility at adjacent levels
Composite:
two metal endplates with poly in between, Ball and socket
Viscoelastic:
with or without endplates
Mechanical:
A mechanical artificial disc is usually comprised of two articulating pieces, all of which are the same material (e.g. metal) or a composite metal and ceramic
Doesnot replicate mechanics of spine
Simple design
based on concept of synovial joint arthroplasty(hip, knee)
accelerated dgeneration of surrounding structure:
facets, UV joint, ligaments
Prodisc-C® Cervical Disc:
2 cobalt chromium endplates and
1 ultra-high molecular weight polyethylene inlay
Inlay technically separate from the endplate,
but it locks into the lower metal, function as a single after installation
Upper endplate has a highly polished divot
plastic dome fits and moves
metal surfaces coated with a titanium plasma spray
helps hold the artificial disc in place and promote bony growth.
Endplate sandwiched:
eg: Bryan Cervical disc
polycarbonate urethane nucleus
rests between two titanium alloy “shells”
Saline innucleus adds compression to disc
Prestige cervical disc:
made of a titanium ceramic composite and titanium carbide
“ball and socket” design,
This design and composition make highly durable and give spine outstanding motion at one- and two-disc levels in cervical spine
Endplates each have two low profile keels to help secure it to bone
Artificial disc permits spine to flex, extend, side bend, and rotate while maintaining alignment, height, and curvature
Unconstrained:
Excess ROM, cost of instability
Semiconstrained:
Constrained:
Limits movement via Keel
pressure on Facet joints
Stable
3mm disc space required prior to CDR
Avoid overstuffing of implant:
Facet joint distraction,
Pritam Patil Knee Project
This document discusses the design and analysis of a femoral component for a total knee replacement. It describes the key features of the natural knee joint and conditions that require knee replacement surgery. The goals of knee replacement surgery and design considerations for the femoral component are outlined. The document then walks through the CAD modeling and finite element analysis of a femoral component, including applying constraints, materials properties, and loads for static stress and fatigue analysis. The analysis shows stress is reduced by adding fillets and chamfers to edge features. References on knee implant design and materials properties are also provided.
Below knee amputation and its Rehabilitation.pptx
This document discusses different levels of lower limb amputation including partial foot, transtibial, transfemoral, and transmalleolar amputations. It also covers considerations for determining the appropriate amputation level such as circulation, cause of amputation, skin blood supply, and lever arm. Key aspects of the surgical procedure and residual limb construction are described. Additionally, the document outlines various prosthetic foot and suspension options, their advantages and disadvantages. Non-articulated feet like SACH feet provide stability while articulated feet allow for more natural movement. Suspension systems include supracondylar, brim, sleeve, suction, and joint/thigh corset methods.
Screws and plates fixation
Screw and plates are most common used devices in orthopedics. However, sometimes we forget their principles, so this presentation hopes to review most their problems. Thank you for your attention!
Robot Configuration - 1
This document discusses different types of industrial robots classified by their arm configuration, power source, and path control. It describes Cartesian robots which move along three orthogonal axes and have a rectangular working envelope. Cylindrical robots use a vertical column that can rotate and slide up/down, giving them a cylindrical working volume. Both robot types have advantages like payload capacity and work area, as well as disadvantages like limited movement directions and lower accuracy for cylindrical robots. Common applications include pick and place, assembly, welding, and machine loading/unloading.
Below knee prosthetic components.pptx
The patellar-tendon-bearing socket is made of laminated or molded plastic that provides an intimate fit over the entire area of the amputated portion of the limb, including the distal end. The anterior wall of the socket is high enough to encompass the distal half of the patella while the posterior wall rises slightly higher than the apex of the in- ward bulge of the socket at the level of the patellar tendon. The medial and lateral walls are slightly higher than the anterior wall to control mediolateral forces applied to the stump, thereby enhancing stability, in this plane. The basic PTB socket also incorporates a soft insert liner
Provide:
The PTB socket provides total contact with the stump.
This feature helps to prevent edema, provides some additional support area (although the end of the stump cannot tolerate much pressure), and probably provides better sensory feedback to the wearer because of the greater area of contact between the amputated limb and the socket
Air cushion Socket
One of the designs, the PTB air-cushion socket, consists of an elastic inner sleeve (stockinette impregnated with silicone rubber) within a rigid outer shell and cap. A sealed chamber between these two walls contains air at atmospheric pressure. Distal support is provided by the tension of the sleeve itself and by compression of the air sealed in the chamber.
The advantages of the air-cushion socket are that is offers a possibility for higher distal loading,
Maintains distal contact even when limb volume changes slightly,
Lessens skin damage due to stretching of skin against an unyielding surface.
The increased distal loading may enhance circulation by decreasing the need for more constrictive proximal loading.
Two major difficulties are that it is complicated to fabricate and, once completed, modifications are very difficult.
Other Socket Variations
In addition to the variations-described above, which relate primarily to weight-bearing characteristics.
Other variations of the basic PTB socket involve the upward extension of the anterior, medial, and lateral walls to provide al- ternate means of suspension.
Since these designs relate to suspension, they are described in the section that follows.
Supracondylar Suprapetellar System
The basic PTB prosthesis is suspended by means of a supracondylar cuff ,which is attached to the socket in the posteromedial and posterolateral areas, and encircles the thigh just above the femoral epicondyles and patella
. The supracondylar cuff serves-primarily to retain the prosthesis on the stump.
It provides only slight assistance for mediolateral stability but does resist forces that tend to force the knee into hyperextension.
Most amputees, with the possible exception of those with very-short or painful stumps, find the stump-socket pressures well within their tolerance with this type of suspension.
The supracondylar/suprapatellar (SC/SP) suspension system has similarly high medial and lateral.
Evolution of hip disarticulation prosthesis
This presentation help to know the development of hip disarticulation prosthesis in developing P&O field.
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Briard Jl. Are All Mb Knees The Same. Slide 1 28
- 1. Are all MB knees the same? Is MB really better than FB? Jean-Louis Briard
- 3. #1 Maximum Conformity Can be achieved through: Multi-radius sagittal femoral geometry with a distal sphere Constant radius sagittal FT geometry with a posterior sphere A - SPHERICAL DESIGNS B -OVOID DESIGNS Never spherical Coronal & sagittal radius are different
- 4. Multi-radius sagittal femoral geometry: J curve with a distal sphere: S2 Extensive area contact near to extension (R: 50mm ) But circular line contact in Flexion LCS & Generics, Interax ISA, Genesis II/ Profix, Innex, Link TACK, Cinétique A 1 SPHERICAL DESIGNS S2
- 5. Constant radius sagittal FT geometry with a posterior sphere Contact area more limited in extension (R: 25mm ) Larger contact in flexion Rotaglide, SAL, TRAC, MBK, Oxford TMK A 2 - SPHERICAL DESIGNS
- 9. But in face of V/V tilting and subsequent lift-off which divides the area by 2, 900 mm 2 seems safer Remember with LCS and poor PE, wear is exceptional !
- 11. Multidirectional Unidirectional Study conducted at Leeds University by Hannah McEwen, J.Fisher Has proven the value of the LCS concept designed 30 y ago !
- 12. UHMWPE Kinematics UHMWPE orientates in principle direction of sliding (Pooley & Tabor 1972, Proc.Roy.Soc.Lon.A, 329, 251) Strength increased parallel to sliding but reduced strength transverse to sliding (Wang et al. 1996, Proc.IMechE, 210H, 141) + Multidirectional works as a file ! : Consequence : # 1
- 13. Abrasive Wear Mono directional Multi directional # 2 Limited furrows Huge amount removed
- 14. Fixed vs RP Fixed bearing Multidirectional motion of femoral component relative to bearing RP Mobile bearing Bearing rotation decoupled: Linear rotation at tibial counterface with reduced rotation at femoral counterface Not to speak of Backside wear !
- 17. LCS spinout but very exceptional (4/2000) Stability is an issue
- 25. LCS system Unchanged for 30 years and widely copied today ! Rotating Platform
- 28. LCS spinout but very exceptional (4/2000) Stability is an issue