Mechanically Aligned Arthroplasty

The surgical procedure. A total knee replacement is a surgical procedure where the diseased knee joint is completely replaced by artificial materials that resemble the original knee joint. The orthopedic surgeon removed the end of the femur and the end of the tibia by using metal pieces and sawing the bone, to ensure that he removes the right amount of bone. The end of the femur bone is replaced with metal and the end of the tibia bone is replaced with plastic and metal. A plastic piece was added under the patella because the surface under the patella was damaged as well. These artificial materials, called prosthesis, have smooth surfaces so when they rub against each other, it does not cause damage and is pain-free. The purpose of this surgery is to remove the diseased portions of the joint and replace it with artificial materials to prevent further deterioration and eliminate pain, stiffness, and decreases in function that were caused by the osteoarthritis.

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

The test population was a community subjects with osteoarthritis of the knee who needed a unilateral total knee replacement. Test subjects were recruited and divided into two groups; a control group, and a prehabilitation/exercise group. The control group were dealt with the usual care preparation prior to their operation while the prehabilitation group were given an exercise programme and these exercises were performed under supervision. The exercises were performed three times a week and included resistance training, flexibility, and step training.

The most common indication for total knee replacement is osteoarthritis, or degenerative joint disease. The end stage of osteoarthritis is wearing out of cartilage (smooth, gliding bone ends) resulting in bone-to-bone contact in diseased joints. It is progressive and becomes increasingly painful as the cartilage erodes. Younger people who get knee replacements have damaged their joints by trauma (accidents that destroy joint surfaces), infection, cancer or tumor, and inflammatory conditions such as rheumatoid arthritis.

The knee joint is formed by the articulation of the distal end of the femur and the proximal end of the tibia. The fibula is only involved to the extent that it serves as an attachment site for connective tissue. In this paper, the anatomy of the joint will be discussed.

Hip replacement surgery is one of the most performed orthopedic surgeries around the world with high success rate. According to various studies, the hip implant has shown to have a survival rate of at least 15-20 years. Initially hip replacement surgeries were performed only on elderly patients but due to its high success rate and increasing popularity, it has been considered for the younger patients as well. Younger patients have more daily activities associated with them which leads to wearing of joint surface much sooner than expected. Once the joint is worn off, it is required to be replaced. So, replacing the artificial joint through revision surgery is becoming more common. Revision surgery is always more complex than the original operation

The isometric strength of the quadriceps was significantly different side to side (INV QUAD = 2.72 ± 0.77, UNINV QUAD = 3.07 ± 0.78, quad LSI = 89% ± 14%). The hip drop of the two limbs were weakly related to one another (r= 0.237, p = 0.026), the involved limb demonstrated more hip drop than the uninvolved (INV HIP ADD =14.55 ± 5.05, UNINV HIP ADD = 11.00 ± 5.31). Quadriceps strength symmetry and normalized max knee extensor moment were inversely related to hip drop with a stronger relationship on the surgical limb (INV: QUAD MVIC r = -.341 p = .001, KNEE MOM: r = -.425 p < .001 (n=88), UNINV: QUAD MVIC r = -0.278 p = .009, KNEE MOM: r = -.294 p = .005).

Total hip replacement (THR), also known as total hip arthroplasty (THA), is commonly performed surgical procedure for treatment of the late stage of osteoarthritis of the hip joint throughout the world. Arthritis causes damage to the articular cartilage of the femur and leads to reduced joint mobility and pain. Total hip arthroplasty involves replacement of worn cartilage with an artificial ball-and-socket joint. The surgery provides

Surgery to replace the entire hip is commonly used in treating joint failure mainly caused by osteoarthritis, which is a degenerative joint disease and is caused by the breakdown of cartilage and underlying bone in a joint. The aims of the procedure are to improve the hip function and movement and relieve the joint of pain caused by the osteoarthritis, during this procedure gaps appear between the bones and implant due to grinding of the bone.

On the basis of structural classification, the knee joint falls under synovial joint. That is, it joins femur, thigh bone and one of the largest and strongest bones in our body to the tibia (Schmidler, 2016). In the knee, there are also other two joints: the tibia that joins to the femur and the patella-femoral which also joins the kneecap to the femur (Levangie, 2011). The two joints shape a modified hinge joint that allows the knee to regularly bend and also straighten. They also enable it to slightly turn, and move

Unicompartmental knee arthroplasty (UKA) had been a common surgical treatment1 for single compartment osteoarthritis (OA) other than total knee arthroplasty (TKA) and high tibial osteotomy (HTO). The outcome of UKA is comparable with total knee arthroplasty2; with having the advantages of lesser bone resection, lower risk of infection, lesser thromboembolic event, reduced length of hospitalization3 and early functional recovery4. Furthermore, preservation of the anterior and posterior cruciate ligaments with intact patellofemoral joint and meniscus may allow the operated knee mimicking near normal knee kinetics5, 6. Despite having such reported advantages, patients who underwent UKA surgery were known to have a higher risk of revision

Background: Correct rotational alignment of the femoral component is considered a prerequisite for good knee function and long prosthetic survival after total knee arthroplasty (TKA). Many studies have aimed to find the best method for rotational alignment, but only a few have compared the results with the supposed gold standard on postoperative computer tomography (CT). Furthermore, many previously described methods for rotational alignment of the femoral component require additional preoperative CT-scans or x-rays and/or special intraoperative alignment jigs.

On examination of the left knee, the incisions are well healed. Range of motion is 0-135 degrees with

A torsion over 360 degrees will likely mean the calf cannot be palpated (Mock, et al., 2015), and this method unsuitable. Having an assistant to push on the side of the abdomen in a downwards motion adds to the momentum and can ease correction (Lyons, et al., 2013). A live calf is also advantageous in this method, as spontaneous movements can assist correction (Frazer, et al., 1996). Manual correction itself requires physical strength, and the use of a detorsion rod may be used to aid correction. However this has a danger of damage to the foetus’ limbs, so care must be taken (Lyons, et al.,

Orthopedic robotics has one main point: HEXAPOD. HEXAPOD is the robotic studies of knee biomechanics. The knee joint is a complex structure. There are six degrees of freedom (DoF) between the tibia and the femur controlled by many muscles, tendons, and ligaments. Normal knee flexion involves translation of the tibia along the femur as well as rotation, making knee simulations computationally difficult. Analyzing the biomechanical effects of individual components in the knee can provide relevant information for developing new surgical treatments or prosthetic devices. Measurement of the joint coordinate system (JCS) during passive knee flexion allows CoRE to measure the motion of the tibia relative to the femur pre- and post-surgical treatments. The ability to