1
|
Rivière C, Villet L, Roby GB. Anatomical restoration of the anterior femoral compartment when performing KATKA: the end of the flush anterior femoral cut dogma! Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07405-z. [PMID: 37004532 DOI: 10.1007/s00167-023-07405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023]
Affiliation(s)
- Charles Rivière
- Clinique du Sport Bordeaux-Mérignac, 04 Rue Georges Negrevergne, 33700, Mérignac, France.
- Bordeaux Arthroplasty Research Institute, Centre de l'Arthrose, 06 Rue Georges Negrevergne, 33700, Mérignac, France.
- Personalized Arthroplasty Society, Atlanta, GA, USA.
| | - Loïc Villet
- Clinique du Sport Bordeaux-Mérignac, 04 Rue Georges Negrevergne, 33700, Mérignac, France
- Bordeaux Arthroplasty Research Institute, Centre de l'Arthrose, 06 Rue Georges Negrevergne, 33700, Mérignac, France
- Personalized Arthroplasty Society, Atlanta, GA, USA
| | - Gabriel B Roby
- Clinique du Sport Bordeaux-Mérignac, 04 Rue Georges Negrevergne, 33700, Mérignac, France
- Bordeaux Arthroplasty Research Institute, Centre de l'Arthrose, 06 Rue Georges Negrevergne, 33700, Mérignac, France
- Personalized Arthroplasty Society, Atlanta, GA, USA
| |
Collapse
|
2
|
Saracco A, Rivière C, Bouchard GR, Villet L. Limb alignment changes with knee flexion: A study based on CAS data. Knee 2023; 41:232-239. [PMID: 36736065 DOI: 10.1016/j.knee.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/12/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Recent evidence has questioned the value of standing limb alignment for predicting the adduction moment and forces exerted on healthy and prosthetic knees. The purpose of this study was to assess the lower limb alignment of OA knee patients at various knee flexion angles. The main hypothesis was that lower limb alignment measured throughout knee flexion does not significantly differ between patients displaying different extension alignment (neutral, varus or valgus). METHODS 206 arthritic knee patients undergoing computer-assisted total (CAS) knee prosthesis were included. Frontal limb alignment was assessed in a systematic manner by CAS at three knee positions: extension, 90 degrees of flexion and maximal flexion. The HKA angle at each knee position and the change in HKA angle between two knee positions (delta value) were reported and compared. RESULTS A large proportion of OA patients had significant variation in their lower limb alignment (32% with Δ HKA > 5°). The extended limb deformity tended to reduce with knee flexion: mean of 5° and 6° deformity reduction for varus and valgus patients, 40% and 66% of varus and valgus patients progressed to neutral alignment with 90° knee flexion. Forty percent of neutral extended lower limb did not maintain their neutral alignment but rather progressed to either varus or valgus at 90° knee flexion. CONCLUSIONS Limb alignment in extension is a poor predictor of limb alignment in flexion in OA patients. Only considering the traditional frontal alignment of an extended lower limb for planning knee arthroplasty or osteotomy is likely insufficient.
Collapse
Affiliation(s)
- Alvise Saracco
- Department of Hip & Knee Replacement Surgery - IRCCS San Raffaele Hospital, Milan, Italy; B.A.R.I. (Bordeaux Arthroplasty Research Institute), France.
| | - Charles Rivière
- B.A.R.I. (Bordeaux Arthroplasty Research Institute), France; Clinique du Sport Bordeaux-Mérignac, France
| | - Gabriel R Bouchard
- B.A.R.I. (Bordeaux Arthroplasty Research Institute), France; Clinique du Sport Bordeaux-Mérignac, France
| | - Loïc Villet
- B.A.R.I. (Bordeaux Arthroplasty Research Institute), France; Clinique du Sport Bordeaux-Mérignac, France
| |
Collapse
|
3
|
Rivière C, Villet L, Bouchard Roby G. Anatomical versus mechanical joint reconstruction: time to pick your surgical philosophy! Knee Surg Sports Traumatol Arthrosc 2022; 30:2890-2894. [PMID: 35639105 DOI: 10.1007/s00167-022-07013-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 05/08/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Charles Rivière
- Personalized Arthroplasty Society, Atlanta, GA, USA. .,Clinique de Sport Bordeaux-Mérignac, 04 Rue Georges Nègrevergne, 33700, Mérignac, France. .,Bordeaux Arthroplasty Research Institute, 06 Rue Georges Nègrevergne, 33700, Mérignac, France. .,The Lister Hospital, Chelsea Bridge Rd, London, SW1W 8RH, UK.
| | - Loïc Villet
- Personalized Arthroplasty Society, Atlanta, GA, USA.,Clinique de Sport Bordeaux-Mérignac, 04 Rue Georges Nègrevergne, 33700, Mérignac, France.,Bordeaux Arthroplasty Research Institute, 06 Rue Georges Nègrevergne, 33700, Mérignac, France
| | - Gabriel Bouchard Roby
- Personalized Arthroplasty Society, Atlanta, GA, USA.,Clinique de Sport Bordeaux-Mérignac, 04 Rue Georges Nègrevergne, 33700, Mérignac, France.,Bordeaux Arthroplasty Research Institute, 06 Rue Georges Nègrevergne, 33700, Mérignac, France
| |
Collapse
|
4
|
Rivière C, Jackson W, Villet L, Sivaloganathan S, Barziv Y, Vendittoli PA. Specific case consideration for implanting TKA with the Kinematic Alignment technique. EFORT Open Rev 2021; 6:881-891. [PMID: 34760288 PMCID: PMC8559564 DOI: 10.1302/2058-5241.6.210042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The Kinematic Alignment (KA) technique for total knee arthroplasty (TKA) is an alternative surgical technique aiming to resurface knee articular surfaces.The restricted KA (rKA) technique for TKA applies boundaries to the KA technique in order to avoid reproducing extreme constitutional limb/knee anatomies.The vast majority of TKA cases are straightforward and can be performed with KA in a standard (unrestricted) fashion.There are some specific situations where performing KA TKA may be more challenging (complex KA TKA cases) and surgical technique adaptations should be included.To secure good clinical outcomes, complex KA TKA cases must be preoperatively recognized, and planned accordingly.The proposed classification system describes six specific issues that must be considered when aiming for a KA TKA implantation.Specific recommendations for each situation type should improve the reliability of the prosthetic implantation to the benefit of the patient.The proposed classification system could contribute to the adoption of a common language within our orthopaedic community that would ease inter-surgeon communication and could benefit the teaching of the KA technique. This proposed classification system is not exhaustive and will certainly be improved over time. Cite this article: EFORT Open Rev 2021;6:881-891. DOI: 10.1302/2058-5241.6.210042.
Collapse
Affiliation(s)
- Charles Rivière
- Clinique du Sport, Bordeaux-Mérignac, France.,Personalized Arthroplasty Society, Atlanta, Georgia, USA
| | - William Jackson
- Personalized Arthroplasty Society, Atlanta, Georgia, USA.,Nuffield Orthopaedic Centre, Headington, Oxford, UK
| | - Loïc Villet
- Clinique du Sport, Bordeaux-Mérignac, France.,Personalized Arthroplasty Society, Atlanta, Georgia, USA
| | - Sivan Sivaloganathan
- Personalized Arthroplasty Society, Atlanta, Georgia, USA.,South-West London Elective Orthopaedic Centre, Epsom, UK
| | - Yaron Barziv
- Personalized Arthroplasty Society, Atlanta, Georgia, USA.,Shamir Medical Center, Zriffin, Israel
| | - Pascal-André Vendittoli
- Personalized Arthroplasty Society, Atlanta, Georgia, USA.,Département de Chirurgie, Université de Montréal, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada
| |
Collapse
|
5
|
Rivière C, Logishetty K, Villet L, Maillot C. Calipered kinematic alignment technique for implanting a Medial Oxford®: A technical note. Orthop Traumatol Surg Res 2021; 107:102859. [PMID: 33601029 DOI: 10.1016/j.otsr.2021.102859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 02/03/2023]
Abstract
This note describes a surgical technique to kinematically align a medial Oxford® UKA. Applying kinematic alignment principles is an alternative, personalised, physiological, and potentially clinically advantageous method for implanting the medial Oxford® UKA. Further investigations are needed to better define the reproducibility and clinical impact of this new surgical technique.
Collapse
Affiliation(s)
- Charles Rivière
- MSK Lab, Imperial College London, Sir Michael Uren Hub, White City Campus 86, Wood Lane, W12 0BZ, London, UK; Personalized Arthroplasty Society Montréal, Canada; Clinique du Sport, 04, rue Georges-Negrevergne, 33700 Mérignac, France; The Lister Hospital, Chelsea Bridge rd, London, UK.
| | - Kartik Logishetty
- MSK Lab, Imperial College London, Sir Michael Uren Hub, White City Campus 86, Wood Lane, W12 0BZ, London, UK
| | - Loïc Villet
- Personalized Arthroplasty Society Montréal, Canada; Clinique du Sport, 04, rue Georges-Negrevergne, 33700 Mérignac, France
| | - Cédric Maillot
- Service de Chirurgie Orthopedique et Traumatologique Bichat-Beaujon, Assistance publique-Hopitaux de Paris, université Sorbonne Paris Cité, Paris, France
| |
Collapse
|
6
|
Wiart Y, Kuntz J, Bergdolt C, Villet L, Rivière C. [Alignment techniques for implantation of a total knee endoprosthesis with particular focus on kinematic alignment]. Orthopade 2020; 49:578-583. [PMID: 32500169 DOI: 10.1007/s00132-020-03930-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND This review introduces various techniques for implantation of a total knee endoprosthesis and scrutinizes the "mechanical alignment" of a total knee endoprosthesis, whereby the various alignment concepts are examined. In particular, kinematic alignment, in terms of its significance, the individual steps of the implantation technique and the data collected, will be examined in more detail. METHODS Improvement in the clinical results after implantation of a total knee endoprosthesis can be achieved by a personalized, individualized, physiological implantation that respects the unique anatomical characteristics of each patient. In recent years, many alternative alignment techniques have been developed, some of them showing promising approaches. RESULTS The kinematic implantation technique can be performed reliably and inexpensively, and shows good biomechanical results. Although the first clinical results are encouraging, further studies should be carried out to determine the limits of optimal alignment.
Collapse
Affiliation(s)
- Yann Wiart
- Endoprothetikzentrum, Theresienkrankenhaus, Mannheim, Deutschland
| | - Johannes Kuntz
- Endoprothetikzentrum, Theresienkrankenhaus, Mannheim, Deutschland
| | | | - Loïc Villet
- Centre de l'arthrose, Clinique du Sport, Mérignac, Frankreich
| | - Charles Rivière
- Centre de l'arthrose, Clinique du Sport, Mérignac, Frankreich. .,South West London Elective Orthopaedic Centre, Epsom General Hospital, MSK Lab - Imperial College London, KT18 7EG, Epsom, Surrey, Großbritannien.
| |
Collapse
|
7
|
Abstract
Multimodal protocols for pain control, blood loss management and thromboprophylaxis have been shown to benefit patients by being more effective and as safe (fewer iatrogenic complications) as conventional protocols.Proper patient selection and education, multimodal protocols and a well-defined clinical pathway are all key for successful day-case arthroplasty.By potentially being more effective, cheaper than and as safe as inpatient arthroplasty, day-case arthroplasty might be beneficial for patients and healthcare systems. Cite this article: EFORT Open Rev 2018;3:130-135. DOI: 10.1302/2058-5241.3.170031.
Collapse
Affiliation(s)
- Stefan Lazic
- South West London Elective Orthopaedic Centre, UK
| | | | | | | | - Loïc Villet
- Centre de l'arthrose - Clinique du sport, Mérignac, France
| | - Charles Rivière
- South West London Elective Orthopaedic Centre, UK.,MSK Lab, Imperial College London, UK
| |
Collapse
|
8
|
Rivière C, Lazic S, Villet L, Wiart Y, Allwood SM, Cobb J. Kinematic alignment technique for total hip and knee arthroplasty: The personalized implant positioning surgery. EFORT Open Rev 2018; 3:98-105. [PMID: 29657851 PMCID: PMC5890135 DOI: 10.1302/2058-5241.3.170022] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Conventional techniques for hip and knee arthroplasty have led to good long-term clinical outcomes, but complications remain despite better surgical precision and improvements in implant design and quality. Technological improvements and a better understanding of joint kinematics have facilitated the progression to ‘personalized’ implant positioning (kinematic alignment) for total hip (THA) and knee (TKA) arthroplasty, the true value of which remains to be determined. By achieving a true knee resurfacing, the kinematic alignment (KA) technique for TKA aims at aligning the components with the physiological kinematic axes of the knee and restoring the constitutional tibio-femoral joint line frontal and axial orientation and soft-tissue laxity. The KA technique for THA aims at restoring the native ‘combined femoro-acetabular anteversion’ and the hip’s centre of rotation, and occasionally adjusting the cup position and design based on the assessment of the individual spine-hip relation. The key element for optimal prosthetic joint kinematics (hip or knee) is to reproduce the femoral anatomy. The transverse acetabular ligament (TAL) is the reference landmark to adjust the cup position.
Cite this article: EFORT Open Rev 2018;3:98-105. DOI: 10.1302/2058-5241.3.170022
Collapse
Affiliation(s)
- Charles Rivière
- MSK Lab, Imperial College London, UK; South West London Elective Orthopaedic Center, UK
| | - Stefan Lazic
- South West London Elective Orthopaedic Center, UK
| | | | - Yann Wiart
- Unfallchirurgie, Theresienkrankenhauss Mannheim, Germany
| | | | | |
Collapse
|
9
|
Villet L, Laville JM. [Shelf acetabuloplasty in Legg-Perthes-Calve disease]. Rev Chir Orthop Reparatrice Appar Mot 2003; 89:234-41. [PMID: 12844047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
PURPOSE OF THE STUDY The purpose of this study was to demonstrate the contribution of shelf acetobuloplasty for the treatment of Legg-Perthes-Calve disease. MATERIAL Eighteen children with Legg-Perthes-Calve disease were operated on between 1992 and 2001. Mean age at diagnosis was 7 years 2 months, and mean age at surgery was 8 years 5 months (range 5-13 years). Mean motion was limited -25 degrees in abduction and internal rotation preoperatively. The radiological classification was: 2 Catterall II Herring B with signs of risk for the head, 8 IIB, 1 III C, 2 IV B, 3 IV C, and 2 at the sequelar stage. Mean excentration was 6.5 mm and mean overhang was 10.2 mm. METHOD The indication for surgery was aggravation of the excentration or advanced revascularization. An iliac graft was embedded in the supralimbic and covered with a rectus femoris tendon which, left continuous, provided elastic support. A bermuda cast was used in 17 cases and immediate weight-bearing in 11. The patients were hospitalized 36 hours. RESULTS Sixteen patients were reviewed at mean follow-up of 3 years 2 months (2 lost to follow-up). There were no complications. Clinically, the patients were pain free. Three patients had persistent limping 10 moderate limitation of motion, and three had severe stiffness. Radiologically, head covering was good in 15 cases, and joint congruency was achieved in 15 (11 of which were concentric). Shelf acetabuloplasty was considered useful in 12 cases, not useful in 1 after complete lysis of a poorly positioned graft, and of uncertain usefulness in 3 (including 2 cases treated at the sequalar stage). DISCUSSION Femoral osteotomy for varisation and pelvic osteotomy for reorientation or enlargement of the acetabulum are effective but have certain drawbacks (limitation of abduction, leg length discrepancy, reintervention to remove material). The excellent integration of the shelf graft at mid-term is a good sign of correct head-acetabulum adaptation, with radiological and clinical results similar to other techniques. Joint stiffness and limping are observed in very severe forms where the prognosis depends on the stage of the disease. CONCLUSION The patients in this series have not yet all reached maturity. Shelf plasty is a rapid, easily-performed, and safe means of enabling weight-bearing in Legg-Perthes-Calve hips undergoing excentration and beginning revascularization.
Collapse
Affiliation(s)
- L Villet
- Chirurgie Infantile, CHD Félix-Guyon, 97405 Saint-Denis-de-la-Réunion
| | | |
Collapse
|