Papers by Keyword: Total Knee Arthroplasty

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Authors: T. Suzuki, Shunsuke Fujibayashi, Yasuaki Nakagawa, Iwao Noda, Takashi Nakamura
Authors: Sok Chol Kim, Hironobu Oonishi, Hiroyuki Oonishi Jr., Masayuki Kyomoto, Mikio Iwamoto, Masaru Ueno, Hirotsugu Ohashi
Abstract: In the late 1970s, based on good clinical results in total hip prostheses, the use of a combination of alumina ceramics and ultra-high molecular weight polyethylene (UHMWPE) was begun for total knee prostheses (TKPs) in order to reduce UHMWPE wear. In this study, to examine the in vivo efficacy of the alumina ceramic bearing surfaces of TKPs, we compared retrieved alumina ceramic TKPs with cobalt-chrome (Co-Cr) alloy TKPs by surface observations and linear wear measurements. In scanning electron microscopic observations, many scratches due to clinical use were observed only on the retrieved Co-Cr alloy femoral components. The damage in the form of scratches on the articulating surface was linear and was produced by rubbing against the Co-Cr alloy surface. The linear wear rate of the retrieved Co-Cr alloy TKPs was 0.027–0.358 mm/year. In contrast, the wear of the retrieved alumina ceramic TKPs was stably low and linear; the linear wear rate was estimated to be 0.026 mm/year. The lower wear rate and milder nature of wear observed in the TKPs with the combination of UHMWPE inserts and alumina ceramic femoral components suggest the possibility of the retention of high performance even during prolonged clinical use.
Authors: Hironobu Oonishi, Sok Chol Kim, Hiroyuki Oonishi Jr., Masayuki Kyomoto, Mikio Iwamoto, Masaru Ueno, Hirotsugu Ohashi
Abstract: In the late 1970s, we started the clinical use of total knee prostheses (TKPs) composed of alumina ceramic. In this study, we investigated the long-term clinical performance of ceramic TKPs. First-generation ceramic TKPs were used between 1981 and 1985; second-generation TKPs, between 1990 and 1996 and third-generation TKPs, between 1993 and 1998. We examined the findings of clinical radiographic observation. A total of 137 first-generation ceramic TKPs were followed up for 20–23 years after implantation. All the rates of loosening, sinking and revision were higher with cementless fixation than with cemented fixation. In the second- and third-generation TKPs, all the components were implanted using bone cement. In 249 joints that were followed up for 6–14 years, neither loosening nor sinking was observed. No osteolysis was observed in any case. We compared the wear of metal TKPs and ceramic TKPs that were retrieved after long-term use. Metal TKPs exhibited a higher wear rate than ceramic TKPs, and they also exhibited scratched surface damages. The lower wear rate and considerably less surface damage observed in our previous study suggest the long-term durability and performance of ceramic TKPs.
Authors: Sok Chol Kim, Hironobu Oonishi, Hiroyuki Oonishi Jr., Hirotsugu Ohashi
Abstract: Improved cement technique by interposing less than two layers of hydroxyapatite (HA) granules between bone and bone cement at the cementing (Interface Bioactive Bone Cement : IBBC) have been performed in total knee arthroplasty (TKA). 140 knees (120 patients) could be followed up clinically and radiologically. As a control, clinical results of TKA with conventional cementing (Non-IBBC) were used. In IBBC cases, the appearance rate of the radiolucent lines on the tibial components and the periprosthetic osteolysis of the tibial components were significantly low. In IBBC, bone cement bound to HA mechanically immediately after surgery and HA granules bound to the bone physicochemically after bone ingrowth into the spaces around the HA granules. Thus, we believe that IBBC is a method combining the advantage of cementless HA coating and bone cement.
Authors: Masao Akagi, T. Asano, Takashi Nakamura, T. Ueo, Y. Matsusue, C. Hamanishi, Takao Yamamuro
Authors: Dan Calafeteanu, Dan Tarnita, Marius Catana, Daniel Calin, Daniela Tarniţă
Abstract: In this paper, using 3D finite element method and starting from the virtual model of the human knee joint-prosthesis assembly, we investigate the effects of antero-posterior tibial slope on contact stresses in the three components of total knee prosthesis. Using AnsysWorkbench15.07 software, the stress and displacements maps are obtained for knee-prosthesis assemblies and for their components, considering two loading force: 800N and 2400N and two cases of prosthetic knee varus slope: 176o and b) 191o. For each prosthesis-knee assembly and for each considered force, two variants of antero-posterior tibial slope were considered: 00 and 50.
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