Use the Right Looking Glass When You Do Caliper-verified Kinematically Aligned TKA!
Ontology highlight
ABSTRACT:
SUBMITTER: Howell SM
PROVIDER: S-EPMC9108522 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
Publications
Use the Right Looking Glass When You Do Caliper-verified Kinematically Aligned TKA!
Arthroplasty today 20220510
Similar Datasets
Project description:This study presents a surgical technique for kinematically aligned medial unicompartmental knee arthroplasty with the MOTO (Medacta Corporate, Switzerland) partial knee implant. This technique aims to replicate the native medial femoral and tibial morphology by providing caliper-verified bone resections and kinematic alignment principles. The paper provides a comprehensive overview of the surgical steps and discusses the implications for implant longevity.
| S-EPMC11345933 | biostudies-literature
Project description:BackgroundMechanically aligned total knee arthroplasty (MATKA) is a well-established procedure. Kinematically aligned TKA (KATKA) has been proposed to restore and preserve pre-arthritic knee anatomy. However, normal knee anatomy varies widely, and there have been concerns regarding restoring unusual anatomy. Accordingly, restricted KATKA (rKATKA) was introduced to reproduce constitutional knee anatomy within a safe range. This network meta-analysis (NMA) aimed to evaluate the clinical and radiological outcomes of the surgeries.MethodsWe performed a database search on August 20, 2022, which included randomized controlled trials (RCTs) comparing any two of the three surgical TKA techniques for knee osteoarthritis. We conducted a random-effects NMA within the frequentist framework and evaluated confidence in each outcome using the Confidence in Network Meta-Analysis tool.ResultsTen RCTs with 1,008 knees and a median follow-up period of 1.5 years were included. The three methods might result in little to no difference in range of motion (ROM) between methods. In patient-reported outcome measures (PROMs), the KATKA might result in a slight improvement compared with the MATKA (standardized mean difference, 0.47; 95% confidence interval [CI], 0.16-0.78; very low confidence). There was little to no difference in revision risk between MATKA and KATKA. KATKA and rKATKA showed a slight valgus femoral component (mean difference [MD], -1.35; 95% CI, -1.95-[-0.75]; very low confidence; and MD, -1.72; 95% CI, -2.63-[-0.81]; very low confidence, respectively) and a slight varus tibial component (MD, 2.23; 95% CI, 1.22-3.24; very low confidence; and MD, 1.25; 95% CI, 0.01-2.49; very low confidence, respectively) compared with MATKA. Tibial component inclination and hip-knee-ankle angle might result in little to no difference between the three procedures.ConclusionsKATKA and rKATKA showed similar ROM and PROMs and a slight variation in the coronal component alignment compared with MATKA. KATKA and rKATKA are acceptable methods in short- to mid-term follow-up periods. However, long-term clinical results in patients with severe varus deformity are still lacking. Surgeons should choose surgical procedures carefully. Further trials are warranted to evaluate the efficacy, safety, and subsequent revision risk.
| S-EPMC10124064 | biostudies-literature
Project description: Not available
| S-EPMC1800336 | biostudies-literature
Project description:BackgroundClinical outcomes of kinematically aligned total knee arthroplasty (KA-TKA) have been reported as comparable or superior to those of mechanically aligned TKA (MA-TKA). However, cruciate-retaining prostheses have mostly been used for KA-TKA. This study used medial pivot knee prostheses for KA-TKA, and knee kinematics after KA-TKA were assessed and compared with those after MA-TKA.MethodsThirteen knees in 9 patients undergoing primary TKA (8 KAs, 5 MAs) were subjected to two-dimensional (2D) to three-dimensional (3D) registration analysis at 1 year postoperatively. Each patient performed weight-bearing activities, and movements were recorded as intermittent digital radiographic images. Three-dimensional implant positions during activities were analyzed for anterior-posterior translation in the sagittal plane, condylar liftoff and mediolateral translation in the coronal plane, and femoral rotation in the axial plane.ResultsPosterior translation of the lateral femoral condyle from 0° to 100° was larger in KA-TKA than in MA-TKA (P = .006). The degrees of condylar liftoff and mediolateral translation were comparable between TKAs. Total external rotation of the femoral component relative to tibial component was significantly greater for KA-TKA (7.7 ± 5.2°) than for MA-TKA (1.3 ± 3.3°; P = .03). The kinematic path of the femoral component revealed greater medial pivoting motion in KA-TKA than in MA-TKA.ConclusionsKA-TKA using a medial pivot knee prosthesis successfully reproduced the medial pivot pattern and achieved larger femoral external rotation relative to the tibia than MA-TKA. KA-TKA was able to maximize the primary concept of the medial pivot knee prosthesis.
| S-EPMC8666599 | biostudies-literature
Project description:AimsNearly 99,000 total knee arthroplasties (TKAs) are performed in UK annually. Despite plenty of research, the satisfaction rate of this surgery is around 80%. One of the important intraoperative factors affecting the outcome is alignment. The relationship between joint obliquity and functional outcomes is not well understood. Therefore, a study is required to investigate and compare the effects of two types of alignment (mechanical and kinematic) on functional outcomes and range of motion.MethodsThe aim of the study is to compare navigated kinematically aligned TKAs (KA TKAs) with navigated mechanically aligned TKA (MA TKA) in terms of function and ROM. We aim to recruit a total of 96 patients in the trial. The patients will be recruited from clinics of various consultants working in the trust after screening them for eligibility criteria and obtaining their informed consent to participate in this study. Randomization will be done prior to surgery by a software. The primary outcome measure will be the Knee injury and Osteoarthritis Outcome Score The secondary outcome measures include Oxford Knee Score, ROM, EuroQol five-dimension questionnaire, EuroQol visual analogue scale, 12-Item Short-Form Health Survey (SF-12), and Forgotten Joint Score. The scores will be calculated preoperatively and then at six weeks, six months, and one year after surgery. The scores will undergo a statistical analysis.DiscussionThere is no clear evidence on the best alignment for a knee arthroplasty. This randomized controlled trial will test the null hypothesis that navigated KA TKAs do not perform better than navigated MA TKAs. Cite this article: Bone Jt Open 2021;2(11):945-950.
| S-EPMC8636290 | biostudies-literature
Project description:Carbon nanotubes (CNTs), due to excellent electronic properties, are emerging as a promising semiconductor for diverse electronic applications with superiority over silicon. However, until now, the supposed superiority of CNTs by "head-to-head" comparison within a well-defined voltage range remains unrealized. Here, we report aligned CNT (ACNT)-based electronics on a glass wafer and successfully develop a 250-nm gate length ACNT-based field-effect transistor (FET) with an almost identical transfer curve to a "90-nm" node silicon device, indicating a three- to four-generation superiority. Moreover, a record gate delay of 9.86 ps is achieved by our ring oscillator, which exceeds silicon even at a lower supply voltage. Furthermore, the fabrication of basic logic gates indicates the potential for further digital integrated circuits. All of these results highlight ACNT-based FETs on the glass wafer as an effective solution/platform for further development of CNT-based electronics.
| S-EPMC10959407 | biostudies-literature
Project description: Not available
| S-EPMC7320866 | biostudies-literature
Project description:Dehydroepiandrosterone (DHEA) and DHEA sulfate together are abundant adrenal steroids whose physiological effects are mediated through their conversion to potent downstream androgens. 3β-Hydroxysteroid dehydrogenase isotype 1 (3βHSD1) facilitates the rate-limiting step of DHEA metabolism and gates the flux of substrate into the distal portion of the androgen synthesis pathway. Notably, a germline, missense-encoding change, HSD3B1(1245C), results in expression of 3βHSD1 protein that is resistant to degradation, yielding greater potent androgen production in the periphery. In contrast, HSD3B1(1245A) encodes 3βHSD1 protein that is easily degraded, limiting peripheral androgen synthesis. These adrenal-permissive (AP) and adrenal-restrictive (AR) alleles have recently been associated with divergent outcomes in androgen-sensitive disease states, underscoring the need to reevaluate DHEA metabolism using HSD3B1 genetics.
| S-EPMC7442716 | biostudies-literature
Project description:BACKGROUND:Although higher levels of hepatitis B virus (HBV) replication in HIV-HBV co-infection may relate to liver disease progression, this has not been completely elucidated. We used expression of hepatitis B core antigen (HBcAg) in liver biopsies from HIV-HBV co-infected and HBV mono-infected patients as a marker for HBV replication, and related these findings to clinical and histological parameters. METHODS:Data from 244 HBV patients were compared with 34 HIV-HBV patients. Liver biopsies were scored for inflammation, fibrosis, HBcAg, and hepatitis B surface antigen. Univariate and multivariate analyses were performed. RESULTS:HBcAg, but not hepatitis B surface antigen, staining was stronger in HIV co-infected than in HBV mono-infected. Co-infected and HBV mono-infected had similar alanine aminotransferase, inflammatory and fibrosis scores, and hepatitis B e antigen status. HBcAg staining correlated with HIV after correcting for HBV DNA and hepatitis B e antigen. CD4 counts and HIV RNA level did not correlate with intensity of HBcAg staining. HBV DNA levels were higher in HIV co-infected and correlated with HBcAg staining. CONCLUSIONS:By looking at HBcAg as a reflection of HBV replication in HIV-HBV co-infected with controlled HIV, our findings suggest that these patients may have subtle immune function defects, which could lead to adverse liver disease outcomes.
| S-EPMC4296901 | biostudies-literature
Project description:Epithelial ovarian cancer (EOC) is the deadliest gynaecological malignancy and the eighth most prevalent cancer in women, with an abysmal mortality rate of two million worldwide. The existence of multiple overlapping symptoms with other gastrointestinal, genitourinary, and gynaecological maladies often leads to late-stage diagnosis and extensive extra-ovarian metastasis. Due to the absence of any clear early-stage symptoms, current tools only aid in the diagnosis of advanced-stage patients, wherein the 5-year survival plummets further to less than 30%. Therefore, there is a dire need for the identification of novel approaches that not only allow early diagnosis of the disease but also have a greater prognostic value. Toward this, biomarkers provide a gamut of powerful and dynamic tools to allow the identification of a spectrum of different malignancies. Both serum cancer antigen 125 (CA-125) and human epididymis 4 (HE4) are currently being used in clinics not only for EOC but also peritoneal and GI tract cancers. Screening of multiple biomarkers is gradually emerging as a beneficial strategy for early-stage diagnosis, proving instrumental in administration of first-line chemotherapy. These novel biomarkers seem to exhibit an enhanced potential as a diagnostic tool. This review summarizes existing knowledge of the ever-growing field of biomarker identification along with potential future ones, especially for ovarian cancer.
| S-EPMC9955065 | biostudies-literature