Abstract
Total knee replacement (TKR) has been performed for patients with end-stage knee joint arthritis to relieve pain and gain functions. Most knee replacement patients can gain satisfactory knee functions; however, the range of motion of the implanted knee is variable. There are many designs of TKR implants; it has been suggested by some researchers that customized implants could offer a better option for patients. Currently, the 3-dimensional knee model of a patient can be created from magnetic resonance imaging (MRI) or computed tomography (CT) data using image processing techniques. The knee models can be used for patient-specific implant design, biomechanical analysis, and creating bone cutting guide blocks. Researchers have developed patient-specific musculoskeletal lower limb model with total knee replacement, and the models can be used to predict muscle forces, joint forces on knee condyles, and wear of tibial polyethylene insert. These available techniques make it feasible to create customized implants for individual patients. Methods and a workflow of creating a customized total knee replacement implant for improving TKR kinematics and functions are discussed and presented in this paper.
Highlights
Total knee replacement (TKR) has been widely used to relieve osteoarthritis pain, and it has been established as a successful treatment for advanced degenerative joint disease
Bonnefoy-Mazure et al [2] presented their research on the evolution of the knee gait kinematic in patients with knee osteoarthritis before and three months after TKR; they pointed out that the disability is still significant for most patients three months after TKR
The objective of this paper was to review the latest development on TKR, propose an approach to making customized total knee replacement implants which can function as close as possible to the normal knee of the patient
Summary
Total knee replacement (TKR) has been widely used to relieve osteoarthritis pain, and it has been established as a successful treatment for advanced degenerative joint disease. Bonnefoy-Mazure et al [2] presented their research on the evolution of the knee gait kinematic in patients with knee osteoarthritis before and three months after TKR; they pointed out that the disability is still significant for most patients three months after TKR. They suggested that a better understanding of the impairments and functional limitations following surgery would help clinicians design rehabilitation programs. Lavernia et al [4] pointed out that the mean bone mineral density (BMD) in the anterior femoral condylar zone in TKR specimens was significantly lower than that in normal specimens without arthroplasty, most likely due to stress shielding
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