mechanism of anterior impingement damage in total knee arthroplasty by scott a. banks, melinda k....
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Both PCL-retaining (Fig. 2-A and 2-B) and PCL-substituting (Fig. 2-C and 2-D) designs from many different implant manufacturers show symmetrical deformation (arrows) on the tibial spine or anterior part of the post at retrieval. Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37- S42 ©2002 by The Journal of Bone and Joint Surgery, Inc.TRANSCRIPT
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Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty
by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge
J Bone Joint Surg AmVolume 84(suppl 2):S37-S42
November 1, 2002
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/2.jpg)
Damage on the anterior part of the post of a retrieved PCL-substituting polyethylene tibial insert.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/3.jpg)
Both PCL-retaining (Fig. 2-A and 2-B) and PCL-substituting (Fig. 2-C and 2-D) designs from many different implant manufacturers show symmetrical deformation (arrows) on the tibial spine or
anterior part of the post at retrieval.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/4.jpg)
Femoral component impingement can cause delamination, forming a shallow groove on the anterior part of the tibial post.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/5.jpg)
Fig. 4-A With knee flexion, there is no contact between the femoral component and the anterior part of the tibial eminence.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/6.jpg)
Implant flexion angle exceeded 0° (hyperextension) during the gait cycle in some patients, independent of the prosthesis design implanted.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/7.jpg)
Fig. 6-A Fluorscopic image, made at heel-strike, of a knee with a mobile-bearing translating and rotating cruciate-retaining prosthesis.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/8.jpg)
Fig. 7-A Prostheses are not aligned perpendicular to the mechanical axis of the bones.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/9.jpg)
Fig. 8-A External goniometric measurements of the knee angle reflect the bone alignment, not the implant alignment.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/10.jpg)
An external marker-based tracking system measured bone position, and a fluoroscopy system tracked the position of the implants as the patients walked on a treadmill.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/11.jpg)
The knee flexion angle was 10° more extended throughout the entire gait cycle when measured with use of the implant position compared with the bone position.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Mechanism of Anterior Impingement Damage in Total Knee Arthroplasty by Scott A. Banks, Melinda K. Harman, and W. Andrew Hodge J Bone Joint Surg Am Volume](https://reader036.vdocuments.net/reader036/viewer/2022062311/5a4d1b7a7f8b9ab0599b8a31/html5/thumbnails/12.jpg)
External goniometry of the skeletal landmarks and fluoroscopic images of the implant position were used to measure knee flexion during kneeling.
Scott A. Banks et al. J Bone Joint Surg Am 2002;84:S37-S42
©2002 by The Journal of Bone and Joint Surgery, Inc.