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Emmanuel Frimpong, Joanne A. McVeigh and Rebecca M. Meiring

( Ostir et al., 2006 ; Salaffi, Carotti, & Grassi, 2005 ). The most cost-effective treatment for advanced knee OA is total knee arthroplasty (TKA) ( Kim et al., 2011 ; Schache, McClelland, & Webster, 2014 ). TKA is considered as a treatment option after all conservative treatment measures have been

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Roger J. Paxton, Jeri E. Forster, Matthew J. Miller, Kristine L. Gerron, Jennifer E. Stevens-Lapsley and Cory L. Christiansen

Knee osteoarthritis (OA) is the most common cause of chronic disability in the United States ( Dillon, Rasch, Gu, & Hirsch, 2006 ). To alleviate OA-related knee pain, more than 700,000 total knee arthroplasties (TKAs) are performed annually ( Kurtz, Ong, Lau, Mowat, & Halpern, 2007 ), with more

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Tsuyoshi Saida, Masayuki Kawada, Daijiro Kuroki, Yuki Nakai, Takasuke Miyazaki, Ryoji Kiyama and Yasuhiro Tsuneyoshi

function and relates to gait performance; thus, it may be a suitable tool to use for evaluating gait function in patients with knee OA ( Barden, Clermont, Kobsar, & Beauchet, 2016 ). Many patients with knee OA undergo total knee arthroplasty (TKA) to regain lower-extremity function. Improved knee function

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Elaine Trudelle-Jackson, Emerenciana Hines, Ann Medley and Mary Thompson

Osteoarthritis of the knee is a frequent cause of mobility disability commonly treated with total knee arthroplasty (TKA) to alleviate symptoms. 1 The number of TKA surgeries performed in the United States is predicted to rise to 3.48 million per year by 2030. 2 Although TKA is considered as a

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Susanne Fuchs, Guido Schuette, Hartmut Witte, and Carsten Oliver Tibesku

A new design of total knee prosthesis without anterior patellar flange was developed to preserve the anatomical shape of the patellofemoral joint. The aim of the current study was to experimentally compare patellofemoral contact area and pressure in a nonreplaced knee, in a knee after implantation of a conventionally designed total knee arthroplasty, and in a knee after implantation of the newly designed total knee arthroplasty without patellar flange. Six cadaveric legs were examined before and after implantation of either a conventional or a newly developed total knee arthroplasty, both without patellar replacement. The essential change in design is the absence of an anterior patellar flange. Contact area and pressure were measured using pressure sensitive films in 45°, 60°, 90°, and 120° of flexion and the results were compared between the different prosthesis designs and with the nonreplaced knee. The prosthesis without patellar flange showed less average and maximum pressure than the conventional prosthesis. Compared with the nonreplaced knee, the conventional prosthesis led to increased average and maximum pressure and decreased contact area. In an experimental test setup, the newly developed total knee arthroplasty without patellar flange showed reduced patello-femoral contact pressure in comparison with a total knee prosthesis with conventional patellofemoral design. This could possibly lead to a lower incidence of anterior knee complaints in patients.

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Matthew B.A. McCullough, Brian D. Adams and Nicole M. Grosland

Third-generation total wrist arthroplasty devices have provided joint stability, relief from pain and increased wrist motion for patients suffering from severe arthritis. While reports of clinical follow-up appointments describe improved wrist function, the improvement in overall upper extremity function and patient perception remains a question. Therefore, the purpose of this study was to assess the upper extremity function in patients that received the Universal 2 total implant system. Eight patients participated in the complete protocol, which included testing activities of daily living as well as surveys to assess patient perception. The findings of the current study suggest that although patients exhibit motion that exceeds the needed amount, many still have a perceived disability.

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Patrice Rougier, Dalila Belaid, Sylvie Cantalloube, Delphine Lamotte and Jacques Deschamps

To assess the postural strategies developed by patients after total hip arthroplasty (THA), 14 patients were measured 12 days after surgery. The respective role played by both sound and prosthetic legs and the compensatory mechanisms were assessed through a separate measure of the center-of-pressure (CP) trajectories under each foot. The movements of the center-of-gravity (CG) were estimated from those of the resultant CP to determine postural performance. The postural behavior was compared with those of a group of age-matched healthy subjects required to adopt a slightly asymmetrical weight distribution. Patient results indicate greater movements for both plantar and resultant CP displacements, principally along the antero-posterior (AP) axis, a decreased contribution of the hip mechanisms in the production of CP displacements along the medio-lateral (ML) axis, greater resultant CP and CG movements along the AP axis and increased differences between CP and CG along both ML and AP axes. The postural specificity of the THA patients appears to be due to a global sensorimotor impairment that alters the control of the loading-unloading mechanism at the hip level.

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Kerry E. Costello, Janie L. Astephen Wilson, William D. Stanish, Nathan Urquhart and Cheryl L. Hubley-Kozey

arthroplasty may be indicated once nonsurgical interventions become ineffective. 4 Under this model, patients spend years living with pain and disability, and the underlying disease processes are not addressed. A better understanding of factors involved in OA progression is essential to inform interventions

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Satoshi Hamai, Ken Okazaki, Satoru Ikebe, Koji Murakami, Hidehiko Higaki, Hiroyuki Nakahara, Takeshi Shimoto, Hideki Mizu-uchi, Yukio Akasaki and Yukihide Iwamoto

The purpose of this study was to investigate in vivo kinematics in healthy and osteoarthritic (OA) knees during stepping using image-matching techniques. Six healthy volunteers and 14 patients with a medial OA knee before undergoing total knee arthroplasty performed stepping under periodic anteroposterior radiograph images. We analyzed the three-dimensional kinematic parameters of knee joints using radiograph images and CT-derived digitally reconstructed radiographs. The average extension/flexion angle ranged 6°/53° and 16°/44° in healthy and OA knees, with significant difference in extension (P = .02). The average varus angle was –2° and 6° in healthy and OA knees, with a significant difference (P = .03). OA knees showed 1.7° of significantly larger varus thrust (P = .04) and 4.2 mm of significantly smaller posterior femoral rollback (P = .04) compared with healthy knees. Coronal limb alignment in OA knees significantly correlated with varus thrust (R 2 = .36, P = .02) and medial shift of the femur (R 2 = .34, P = .03). Both normal and OA knees showed no transverse plane instability, including anteroposterior, mediolateral directions, or axial rotation. In conclusion, OA knees demonstrated different kinematics during stepping from normal knees: less knee extension, larger varus thrust, less posterior translation, and larger medial shift.

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Brian D. Street and William Gage

authors have no conflicts of interest to disclose. References 1. Finch E , Walsh M , Thomas SG , Woodhouse LJ . Functional ability perceived by individuals following total knee arthroplasty compared to age-matched individuals without knee disability . J Orthop Sports Phys Ther . 1998 ; 27