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Modern concepts of knee implants

Modern concepts of knee implants. Dr. Clemens Menapace FA für Orthopädie und orthop. Chirurgie Ritter v. Schwarzstr. 8, 5400 - Hallein. www.menapace.com. Modern concepts of knee implants. Clemens MENAPACE. M.D. Orthopedy and orthopedic surgery.

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Modern concepts of knee implants

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  1. Modern concepts of knee implants Dr. Clemens Menapace FA für Orthopädie und orthop. Chirurgie Ritter v. Schwarzstr. 8, 5400 - Hallein www.menapace.com

  2. Modern concepts of knee implants Clemens MENAPACE M.D. Orthopedy and orthopedic surgery Director of the Departement for orthopedic and endoskopic joint surgery Ritter v. Schwarzstr. 8 5440-Hallein Guggenbichlerstr, 20 5020-Salzburg www.menapace.com

  3. Modern concepts of knee implants Clemens MENAPACE M.D. Orthopedics and orthopedic surgery Director of the Departement for orthopedic and endoscopic joint surgery Ritter v. Schwarzstr. 8 5440-Hallein Guggenbichlerstr, 20 5020-Salzburg www.menapace.com

  4. Modern concepts of knee implants Dr. Clemens Menapace Department for orthopedic and endoscopic joint surgery www.menapace.com

  5. Modern concepts of knee implants

  6. Modern concepts of knee implants Orthopedic surgery is getting more and more technically demanding

  7. Modern concepts of knee implants Developement of state of the art kneeimplant was impaired by Biological complexity complicated biomechanics complicated anatomy of the knee Technical complexity Component- design problems Problems with materials

  8. Modern concepts of knee implants Complex Biomechanics Biomechanically the knee contains 3 separate joints Medial lateral Femorotibial joint Femoropatellar joint The knee is a multi-ax system: center of ax-rotation changes during cycle of motion Flexion and Extension is a role- and glide - mechanism because of a negativ (decreasing) condyle-radius causing shear-forces During cycle of motion different combination of ligaments provide stability

  9. Modern concepts of knee implants Complex Biomechanics 3 rotational axes of movement 1 axis with moving center of rotation rol & glide movement (translation-rotation) load-aera decreases in flexion (decreasing fc-radius) patellar biomechanic

  10. Modern concepts of knee implants Complex Anatomy

  11. Modern concepts of knee implants In conclusion the Flexion / Extension movement of the knee is not a fixed hinge type system but rather a dynamic role- and glide- mechanism with an endrotation in full extension. Flexion and extension is performed along several axes with dynamic centers of rotation secured statically by changing combinations of ligaments and dynamically by groups/combinations of muscels.

  12. Modern concepts of knee implants Performance-requirements for an efficent kneeimplnat/-endoprothesis Stability Longevity Physiological range of motion without undue stress on components

  13. Modern concepts of knee implants The ultimate goal is to imitate anatomy as close as possible

  14. Modern concepts of knee implants Anatomically correct Decreasing /negativ radius of femurcondyles has to be imitated changing centers of rotation

  15. Modern concepts of knee implants Restore perfect alignement Alignement deficiencies have to be corrected painstakingly to avoid peak-pressure locally valgus varus

  16. Modern concepts of knee implants preop Planning of proper alignément postop

  17. Modern concepts of knee implants Restore perfect ligament tension and balance

  18. Modern concepts of knee implants Combination of low friction interface FemurTibia Ceeramics ceramics Ceramics Polyaethylen Metal Polyaethylen Metal Metal

  19. Modern concepts of knee implants stabel fixation of components to bone cement Press fit screw fixation

  20. Modern concepts of knee implants D e v e l o p m e n t

  21. Modern concepts of knee implants Stoneage of knee-implants

  22. Modern concepts of knee implants GSB-Hinge-Type 1970 semiconstraint Tour de France ?

  23. Modern concepts of knee implants Fixed tbial bearing The Vienna Derby

  24. Modern concepts of knee implants Mobile bearing Back into the future

  25. Modern concepts of knee implants Congruency High contact stress Low contact stress

  26. Modern concepts of knee implants Large contact area reduces contact stress

  27. Modern concepts of knee implants Different qualities of force exacted on a fixed bearing implant

  28. Modern concepts of knee implants Constraint means that shear and torsion forces could be transmitted to fixation interfaces and cause loosening

  29. Modern concepts of knee implants Mobile bearing prevents sheering forces

  30. Modern concepts of knee implants

  31. Modern concepts of knee implants

  32. Modern concepts of knee implants

  33. Modern concepts of knee implants mobile patellar bearing

  34. Modern concepts of knee implants cemented-noncemented mobile bearing system

  35. Modern concepts of knee implants Revision-surgery

  36. Modern concepts of knee implants Constraint systems in use for cases with severe bonedefect Tumor-surgery Revison-surgery

  37. Modern concepts of knee implants Revision-surgery with semiconstraint knee -prosthesis after failure of duocondylar implant

  38. Modern concepts of knee implants Semiconstraint implants for cases with sever bonedefect, instability, malalignement

  39. Modern concepts of knee implants Unicondylar implants

  40. Modern concepts of knee implants Unicondylar implants

  41. Modern concepts of knee implants

  42. Modern concepts of knee implants MGII NEXGEN

  43. Modern concepts of knee implants Mobile bearing knee implant

  44. Modern concepts of knee implants Duocondylar knee implnats Surgical principles of

  45. Modern concepts of knee implants

  46. Modern concepts of knee implants

  47. Modern concepts of knee implants

  48. Modern concepts of knee implants

  49. Modern concepts of knee implants Defining the resection lines by using a weight bearing total limb X-ray Ahlbäcks desease

  50. Modern concepts of knee implants

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