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Improving Accuracy in Knee Arthroplasty Emmanuel Thienpont

1: What is Alignment and Malalignment?
- INTRODUCTION
- MECHANICAL AND ANATOMIC AXES
- MECHANICAL AXIS DEVIATION
- RATIONALE FOR THE JOINT ORIENTATION ANGLES
- MALALIGNMENT
  - Varus Malalignment Test (MAT)
  - Valgus Malalignment Test (MAT)
- MALORIENTATION OF THE ANKLE AND HIP JOINTS
- GROUND REACTION FORCE VECTOR
- CONCLUSION
2: Alignment? How Do We Measure It?
- INTRODUCTION
  - Definition of Planes
  - Standard Postoperative Assessment and the Need for a Better Insight
- KNEE CORONAL (OR FRONTAL) PLANE ASSESSMENT
- KNEE SAGITTAL (OR LATERAL) PLANE ASSESSMENT
- KNEE AXIAL PLANE ASSESSMENT
- CONCLUSION
3: Frontal and Sagittal Alignment in Knee Arthroplasty
- INTRODUCTION
- CONVENTIONAL NAVIGATION
- RESULTS
- CONCLUSION
4: Rotational Alignment in Knee Arthroplasty
- INTRODUCTION
- FEMORAL COMPONENT ROTATION
- TIBIAL COMPONENT ROTATION
- CONCLUSION
5: Finding Anatomical Landmarks in the Normal and Arthritic Knee
- INTRODUCTION
- FEMORAL COMPONENT ALIGNMENT
- TIBIAL COMPONENT ALIGNMENT
  - Sagittal Plane Rotation: Posterior Slope
  - Tibial Component Internal-external Rotation
- FUTURE PROSPECTS FOR MORE ACCURATE ALIGNMENT DURING TKA
6: Patient's Anatomy: To Change or To Reconstruct?
- INTRODUCTION
- CONSTITUTIONAL ALIGNMENT
- GENDER AND MORPHOTYPE
- CONCLUSION
7: Alignment and Biomechanics: A Surgeon's Perspective
- INTRODUCTION
- JOINT LINE IN THE NATIVE KNEE
- JOINT LINE IN THE REPLACED KNEE
- JOINT LINE IN REVISION TKA
- JOINT LINE CHANGEs AND ITS CONSEQUENCES
- CONCLUSION
8: The Impact of the Foot on Weight Bearing Alignment
- INTRODUCTION
- PHYSICAL EXAMINATION
  - Gait Analysis
- FOOT DEFORMITY AND KNEE ALIGNMENT
  - Management of Foot Deformity
- POSTERIOR TIBIAL TENDON DYSFUNCTION
- CAVOVARUS DEFORMITY
- POST-TRAUMATIC DEFORMITY
- NEUROARTHROPATHY
- ANKLE ARTHRITIS
- FOOT DEFORMITY AND KNEE ARTHROPLASTY
  - Order of Correction
- CONCLUSION
9: Intra-articular Impact of Extra-articular Alignment Deformity
- INTRODUCTION
- ASSESSMENT OF THE DEFORMITY
- IMPACT OF EXTRA-ARtICULAR DEFORMITY ON THE ALIGNMENT OF THE KNEE
- TECHNICAL CONSIDERATIONS
  - Intra-articular vs Extra-articular Correction
- CASE ILLUSTRATIONS
  - Case 1
  - Case 2
- SURGICAL ISSUES
- REVIEW OF LITERATURE
- SAGITTAL PLANE AND ROTATIONAL DEFORMITIES
- CONCLUSION
10: Navigation in Knee Arthroplasty
- INTRODUCTION
- PREOPERATIVE PLANNING
  - Surgical Technique
  - Placement of Tracker Pins
- ANATOMY REGISTRATION
11: Mimics Software in Knee Arthroplasty
- INTRODUCTION
- ACCURACY IN KNEE ARTHROPLASTY
- MIMICS
- CONCLUSION
12: Patient Specific Instruments: Past, Present and Future
- INTRODUCTION
- THE PAST
- PATIENT SPECIFIC INSTRUMENTS
- THE PRESENT
- FUTURE DIRECTION
- CONCLUSION
13: MRI and CT-based Cutting Guides Type MyKnee
- INTRODUCTION
- SCIENTIFIC BASIS OF MyKNEE®
- MyKNEE® PREOPERATIVE PLANNING
- MyKNEE® CUTTING GUIDES
- MyKNEE® INTERACTIVE WEBSITE
- MyKNEE® SURGICAL TECHNIQUE
- MyKnee® BENEFITS
- MyKNEE® SPECIALS
  - Economical Aspects
  - Safety Aspects
- PERSONAL EXPERIENCE AND PRELIMINARY RESULTS
- CONCLUSION
14: MRI and CT-based Pinning Guides Type Signature
- INTRODUCTION
- SYSTEM PHILOSOPHY AND SCIENTIFIC BASIS
- STRATEGIC CHOICES OF THE SYSTEM
- TECHNICAL ASPECTS OF THE SYSTEM
  - Total Knee Arthroplasty Simulation Algorithm
    - Anatomical Landmarks and Derived Geometries
    - Cut Planes
- SIGNATURETM PLANNING SOFTWARE
- QUALITY CONTROL
- PRODUCTION OF THE GUIDES
- CONTACT SURFACE OF THE GUIDES
- LEAD TIME OF THE SYSTEM
- PATIENT'S ANONYMITY
- INTRAOPERATIVE USE OF THE GUIDES
- PRACTICAL ADMINISTRATIVE CONSIDERATIONS–A TEAM-BASED APPROACH
- CONCLUSION
- ACKNOWLEDGMENTS
15: Kinematically Aligned TKA with MRI-based Cutting Guides
- INTRODUCTION
- THE THREE AXES THAT DESCRIBE THE KINEMATICS OF THE KNEE
- A SIMPLE METHOD FOR FINDING THE THREE KINEMATIC AXES
- USE OF SHAPE-MATCHING TO KINEMATICALLY ALIGN THE FEMORAL COMPONENT
- PENALTY FROM ALIGNING THE FEMORAL COMPONENT PERPENDICULAR TO THE MECHANICAL AXIS OF THE FEMUR IS ‘KINEMATIC MALALIGNMENT’
- METHOD OF KINEMATICALLY ALIGNING THE TOTAL KNEE ARTHROPLASTY WITH USE OF PATIENT SPECIFIC CUTTING GUIDES
- PROTOCOL FOR ALIGNING AND OBTAINING MRI OF THE KNEE
- VIRTUAL CONSTRUCTION OF THE 3-DIMENSIONAL ‘ARTHRITIC’ AND ‘NORMAL’ KNEE MODEL
- VIRTUAL SHAPE-MATCHING THE FEMORAL AND TIBIAL COMPONENTS
- FUNCTION, DESIGN, AND MACHINING OF PATIENT SPECIFIC CUTTING GUIDES
- SIMPLE ALGORITHM FOR RESTORING MOTION AND BALANCING THE KINEMATICALLY ALIGNED TOTAL KNEE ARTHROPLASTY
- SURGICAL TECHNIQUE FOR KINEMATICALLY ALIGNING THE TKA WITH PATIENT SPECIFIC CUTTING GUIDES
- KINEMATICALLY ALIGNED TKA ENABLES A HIGH LEVEL OF EARLY SATISFACTION AND RAPID RECOVERY
- A PREDICTION OF THE LONG-TERM CLINICAL OUTCOME OF KINEMATICALLY ALIGNED TKA
- CONTACT KINEMATICS APPROACH NORMAL IN KINEMATICALLY ALIGNED TKA
- SUMMARY
16: MRI-based Pin Guide Patient Specific Instruments
- INTRODUCTION
- ADVANTAGES AND DISADVANTAGES OF CUSTOMIZATION AND PATIENT SPECIFIC INSTRUMENTATION
- ANATOMICAL LANDMARKS FOR PREOPERATIVE PLANNING
  - For the Femur
  - For the Tibia
- SURGICAL PLANNING WITH PREOPERATIVE SOFTWARE
- AUTHORS’ SURGICAL TECHNIQUE FOR TKA USING PATIENT SPECIFIC INSTRUMENTATION
- CONCLUSION
17: Full Leg and MRI-based Cutting Guides Type Visionaire
- INTRODUCTION
- DESIGN RATIONALE AND PLANNING
- SURGICAL TECHNIQUE
- EXPERIENCES AND RESULTS
- DISCUSSION
- CONCLUSION
18: CT-based Cutting Guides Type Prophecy
- INTRODUCTION
- PROPHECY® PREOPERATIVE NAVIGATION
- Investigation of Efficacy through Cadaveric Testing
- CONCLUSION
- ACKNOWLEDGMENTS
19: CT-based Cutting Guides Type TruMatch
- INTRODUCTION
- OVERVIEW OF THE TruMatch™ SYSTEM
- RATIONALE FOR THE USE OF COMPUTERIZED TOMOGRAPHY
- POTENTIAL ADVANTAGES
- SURGICAL PROCEDURE
- RESULTS
- CONCLUSION
20: Individualized Total Knee Arthroplasty
- INTRODUCTION
- SYSTEM PHILOSOPHY AND DESIGN RATIONALE
- TECHNICAL ASPECTS OF THE SYSTEM
- INTRAOPERATIVE USE OF THE GUIDES
- CONCLUSION
21: Unicompartmental Arthroplasty with Patient Specific Guides
- INTRODUCTION
- IMPORTANCE OF MEDIAL OXFORD IMPLANTATION POSITION
- ADVANCED METHODS FOR IMPROVING ALIGNMENT
- PATIENT SPECIFIC GUIDES FOR THE OXFORD UKA
- PATIENT SPECIFIC IMPLANTATION–BENEFITS FOR UKA IMPLANTATION
- EXPERIENCE WITH OXFORD SIGNATURE– INITIAL RESULTS AND FUTURE PLANS
- CONCLUSION
22: Unicompartmental Arthroplasty with Patient Specific Instruments for the Zimmer Unicompartmental High Flex Knee
- INTRODUCTION
- ADVANTAGES AND DISADVANTAGES OF PATIENT SPECIFIC INSTRUMENTS
- SURGICAL PREOPerative PLANNING
- SURGICAL TECHNIQUE
- DISCUSSION
- CONCLUSION
  - Approval Notice
23: Robotic Knee Arthroplasty Type MAKO Plasty
- INTRODUCTION
- CAUSES OF FAILURE DUE TO SURGICAL ERROR
- HAPTIC ROBOTICS
- SURGICAL TECHNIQUE
- CLINICAL STUDIES
- CONCLUSION
24: Patient Matched Robotic Unicondylar Arthroplasty
- THE PLATFORM TECHNOLOGY: BONE SCULPTING ABILITIES OF THE SCULPTOR ROBOT
- BACKGROUND UNDERSTANDING: THE MORPHOLOGY AND KINEMATICS OF THE NORMAL KNEE
- RECONSTRUCTIVE SURGERY: A NEW RANGE OF MINIMALLY INVASIVE DEVICES
  - First Clinical Trials and Preclinical Testing
- HEALTH ECONOMICS
- CONCLUSION
25: PSI as a Teaching Tool
- INTRODUCTION
- THE RATIONALE FOR THE USE OF PSI AS A TRAINING TOOL FOR TOTAL KNEE ARTHROPLASTY
- THE USE OF PSI AS A TEACHING TOOL
- CONCLUSION
26: Soft Tissue-based Alignment with E-Libra
- INTRODUCTION
- SOFT TISSUE INFLUENCE ON KNEE KINEMATICS AND STABILITY
- SOFT TISSUE-GUIDED ALIGNMENT: THEORY AND TECHNIQUE

INDEX

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Chapter Notes