Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
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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.
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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]
Total Knee Replacement
This document discusses the evolution and design of total knee arthroplasty (TKA). It describes how early TKA designs in the 1970s-1980s led to improved designs that better replicated normal knee biomechanics. The key developments included posterior cruciate ligament retaining versus substituting designs, improved patellofemoral tracking, and converting flexion-extension gaps. The document outlines the surgical technique for TKA, including approaches, bone cuts, ligament balancing, and the goals of restoring alignment and stability while maximizing range of motion.
Primary total knee arthroplasty
Primary Total Knee Arthroplasty has evolved since the 19th century with various prosthetic designs introduced over time. Prosthetic design considerations include femoral rollback, modularity, constraint, and whether to retain or sacrifice the cruciate ligaments. Radiographs are important for preoperative planning to assess alignment and bone defects. Surgical goals include restoring mechanical alignment, joint line, balanced soft tissues, and normal patellofemoral tracking. Key steps include femoral and tibial cuts, balancing the knee in flexion and extension, and addressing any flexion contractures or deformities. Complications can include nerve palsies, vascular issues, stiffness, infections, and loosening. With careful patient selection, planning and technique, total knee
Briard Jl. Are All Mb Knees The Same. Slide 29 53
The document discusses the advantages of rotating platform mobile bearing knee replacements compared to fixed bearing designs. It notes that rotating platforms experience less backside wear and osteolysis than fixed bearings due to their unidirectional motion which reduces wear particles. Studies have shown rotating platforms have failure rates of 97.7-98.3% at 12-20 years compared to higher failure rates for mobile bearings.
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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
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
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
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
Jennings Lm. Wear Of Knee Replacements Influence Of Kinematics And Design
Jennings Lm. Wear Of Knee Replacements Influence Of Kinematics And Design
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
Similar to Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
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.
Instability in TKR
This document discusses instability after total knee arthroplasty (TKA). It begins by outlining the goals and basic principles of TKA. It then describes the bone cuts made during TKA and emphasizes that resection of the proximal tibia influences both flexion and extension gaps. The document discusses various causes of instability after TKA including improper bone cuts, soft tissue imbalance, and component malpositioning. It provides details on managing different types of instability such as instability in extension, flexion, and mid-flexion. Prevention of instability through proper bone cuts and soft tissue balancing is emphasized.
HIgh Tibial Osteotomy: when and how
1) The document discusses the planning of a high tibial osteotomy (HTO) procedure, including a brief history of osteotomies, knee axis anatomy, indications for HTO, preoperative planning considerations, and techniques for planning correction angles and wedge sizes.
2) Key factors in planning include determining the nature and location of deformity, ideal candidates for HTO vs other procedures, and calculating the needed correction angle based on methods like the Fujisawa scale.
3) Precise planning is important for procedures like open vs closed wedge osteotomy and correcting any concomitant deformities in the sagittal or transverse planes.
Osteotomies around the hip joint
Osteotomies around the hip can involve the femur or pelvis. Femoral osteotomies include intertrochanteric, subtrochanteric, and greater trochanteric osteotomies. Pelvic osteotomies involve the acetabulum. Indications include non-union of the femoral neck, osteoarthritis of the hip, osteonecrosis of the femoral head, and acetabular dysplasia. Specific procedures discussed include varus, valgus, extension, Pauwels, and periacetabular osteotomies. Complications can include non-union, heterotopic ossification, and loss of fixation.
01. knee anatomy
The knee joint is actually two joints: the tibiofemoral joint and the patellofemoral joint. It allows for flexion and extension as the primary motions. The knee is supported by ligaments like the ACL, PCL, and collateral ligaments, as well as menisci that absorb shock and increase stability. Muscles like the quadriceps and hamstrings are responsible for knee flexion and extension. The anatomy of nerves and blood vessels around the knee also make certain injuries more common.
Osteoarthritis
The document discusses considerations for correcting varus deformity during total knee arthroplasty for osteoarthritis. It analyzed 20 patients with over 15 degrees of varus deformity who underwent TKA. The goal of TKA is to restore the mechanical axis of the knee to distribute load evenly and reduce wear. This involves correcting alignment through distal femoral and proximal tibial cuts while balancing the extension and flexion gaps. Restoring proper alignment through the joint line and balancing the soft tissues is important for implant longevity and stability.
Biomechanics of Foot and Ankle complex, CP orthotic management &Tone reducing...
Biomechanics of Foot and ankle complex along with common foot pathology like flatfeet has been discussed.
Types of Flatfeet, pathophysiology & its biomechanics negative impact on gait with Orthotic treatment has been discussed.
Types of CP (hemiplegia and diplegia spastic CP ), its gait patterns and appropriate orthotic management around the ankle and foot complex in child with spastic cp has been discussed including various tone reducing AFOs and Neurophysiology AFOs.
X Ray and MRI of Knee Joint
This document provides an overview of knee x-ray and MRI examinations. It describes the normal anatomy seen on x-rays and MRI, various imaging projections used for the knee, and common pathologies that can be identified. Key indications for knee x-rays are listed as trauma, suspected osteoarthritis, infection, and to evaluate for fractures or joint effusions. Common fractures discussed include tibial plateau fractures and patellar fractures. The document also provides details on measurements taken from knee x-rays.
Disarticulated arthosis
Disarticulation prosthesis
Individuals with knee and hip disarticulation wear prostheses that include the same distal components as prostheses for lower levels.
Any prosthetic foot can be used with either an endoskeleton or exoskeleton shank. The major distinction, therefore, is in the proximal portion of the prostheses.
Plastic molded to provide weightbearing on the ipsilateral ischial tuberosity and buttocks. The person with transpelvic amputation who does not retain the ipsilateral tuberosity or iliac crest has a socket with a higher proximal Trimline, sometimes encompassing the lower thorax.
Congenital vertical talus Pes Plano Valgus
Prof. Anisuddin Bhatti, Paediatric Orthopaedic Surgeon, Dr. Ziauddin University Hospital, Clifton campus Karachi, presented lecture on Congenital Clubfoot and PPV deformity evaluation & treatment. On 31 May 2021 to Resident's of AKUH and others. Acknowledged text & picture source as indicated in reference list.
Femoral deficiency and Prosthetic management (part 2.pptx
This document discusses prosthetic and orthotic management for femoral deficiency and prosthetics (LDFP/PFFD). It covers general factors affecting management, conservative non-surgical options like AFOs and KAFOs, surgical options like Syme ankle disarticulation and rotationplasty, and prosthetic designs for various management approaches. Key points include different prosthesis designs for different Aitken types of femoral deficiency, interface design principles, surgical procedures like Syme and rotationplasty and their associated prosthesis designs, and gait considerations for individuals with LDFP. Bilateral involvement is also briefly discussed.
Total knee replacement - Dr. Sachin M
Total knee replacement involves replacing the knee joint with prosthetic components. Critical elements for success include proper anatomy, biomechanics, soft tissue balancing and alignment. A thorough preoperative evaluation is important. The surgical procedure involves exposing the knee joint through an incision and removing damaged bone and cartilage. Bone cuts are made to prepare the femur and tibia to receive prosthetic components. Proper alignment and soft tissue balancing are crucial. Factors like deformity, bone loss, and patellofemoral tracking must be addressed. Attention to surgical technique and postoperative rehabilitation can provide pain relief and improved function.
Osteotomies around the hip
An osteotomy around the hip is a surgical procedure used to correct biomechanical alignment and load transmission. There are various types of osteotomies of the proximal femur classified by displacement of the distal fragment, anatomical location, and indication. Common osteotomies include McMurray's displacement osteotomy, Pauwel's varus/valgus osteotomy, and Salter's innominate osteotomy. The goal of osteotomies is to improve joint congruity, relieve pain, and correct deformities around the hip joint.
BIOMECHANICS OF FOUR-BAR LINKAGE PROSTHETIC KNEE MECHANISM
Polycentric knee mechanism usually consists of four-bar linkage that provides more than one point of rotation – changing ICOR ( through which it mimics the anatomical knee joint mechanism). four bar linkage knee joint used for transfemoral level of amputation and knee disarticulation amputation levels.
The four-bar linkage knee mechanism is classified into three different categories as per the location of ICOR, amount of knee stability at heel strike and initiation of knee flexion at push-off.
1.Four-bar linkage with elevated Instant Centre
2.Hyper-stabilized four-bar knee mechanism
3.Voluntary control four-bar mechanism
Types of four bar linkage stability, its Biomechanics and alignment criteria has been thoroughly explained.
Basic principles of deformity correction
This document describes basic principles of deformity correction in orthopedics. It defines key concepts like mechanical axis, anatomical axis, joint center points, and joint orientation lines. It also describes how to assess deformities using tests like the MAT (malalignment test) and MOT (malorientation test) to identify sources of malalignment. Critical concepts for correction are introduced, including the CORA (center of rotation of angulation) and rules for determining the type of osteotomy (opening, closing, neutral wedge) based on the relationship between the CORA and correction axis. Treatment approaches are outlined depending on the type of deformity, whether it involves length, angulation, rotation, or translation issues. Maintaining the correction axis on
Lower limb orthosis
A complete description of the lower limb orthosis is available in the following presentation with an in depth understanding of the same.It covers the ankle foot orthosis,Knee orthosis the knee ankle foot orthosis and hip orthosis.
knee joint biomechanics 2nd BPTH Kinesiology
The knee is a synovial joint that allows for flexion and extension as well as some rotational movement. It is made up of the tibiofemoral and patellofemoral joints. The knee ligaments and menisci provide stability and cushioning. Proper alignment and balance of forces across the knee joints are necessary for healthy function. Pathomechanics like genu varum/valgum and instability can disrupt this balance and lead to cartilage damage and osteoarthritis. The patella acts as a lever for the quadriceps muscles but is also susceptible to tracking issues.
TOTAL KNEE REPLACEMENT
Total knee arthroplasty (TKA) is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain from arthritis. The document discusses the relevant anatomy of the knee joint, biomechanics, indications and contraindications for TKA, and key concepts in knee replacement surgery such as femoral rollback and constraint.
Tkr by dr. saumya agarwal
Total knee replacement (TKR) involves replacing the weight-bearing surfaces of the knee joint to relieve pain and correct deformities. The document discusses the anatomy of the knee joint, common conditions requiring TKR such as osteoarthritis and rheumatoid arthritis, the evolution of TKR implant designs, surgical approaches, the procedure, goals of alignment and balancing, and potential complications. Computer-assisted technology can provide real-time feedback on bony cuts and alignment during surgery. While TKR successfully relieves pain in most patients, some may still experience complications such as stiffness, infection, or loosening of implants.
CLUBFOOT Rx Principles AKU.ppt
Prof. Anisuddin Bhatti Paediatric Orthopaedic surgeon Dr. Ziauddin University hospital Clifton Karachi Pakistan Presented Principles & practice in Clubfoot at AKU Orthopaedic Review Course. October 2023. Acknowledged for Some text material & Photo taken from Global Health publication on Ponseti Clubfoot treatment & internet media.
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Biomechanics of Foot and Ankle complex, CP orthotic management &Tone reducing...
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Femoral deficiency and Prosthetic management (part 2.pptx
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BIOMECHANICS OF FOUR-BAR LINKAGE PROSTHETIC KNEE MECHANISM
BIOMECHANICS OF FOUR-BAR LINKAGE PROSTHETIC KNEE MECHANISM
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Briard Jl. How To Correct Extra Articular Deformity. Slide 1 6
- 1. How to correct extraarticular deformity without causing instabilty ? Jean-Louis BRIARD
- 3. Consider shape of the bones + + (reference to the mechanical axis)