Principal Investigator: Nicholas J. Giori, MD, PhD Objectives: Total knee arthoplasty is an effective operation to reduce knee pain from arthritis. Total knee arthroplasty can fail if the knee replacement components are not placed properly on the bone. The alignment of the implant components is thought to be critical to the longevity and success of the knee replacement, and rotational alignment of the femoral and tibial components remains difficult. In this project, an number of studies were carried out to investigate the variability of rotational placement of the femoral and tibial components of total knee arthroplasty and to evaluate the passive kinematics of a knee with advanced osteoarthritis before and after total knee arthroplasty. Work Accomplished: We carried out a number of cadaveric and in vivo studies to evaluate the variability across surgeons of placement of the femoral and tibial components of total knee replacement, and then evaluated the kinematics of knees before and after total knee replacement. We are currently developing novel computer assisted algorithms to improve rotational alignment of total knee replacement and total hip replacement components. We have found that in total knee arthroplasty, rotational alignment is improved on average with the new algorithms we have developed. Expected Outcome: New computer-assisted techniques are being developed to improve rotational alignment of total knee replacement components. Publications Siston RA, Daub AC, Giori NJ, Goodman SB, Delp SL: Evaluation of methods for determining the center of the ankle for computer-assisted total knee replacement. Clin Orthop 2005 439:129-135 Siston RA, Patel JJ, Goodman SB, Delp SL, Giori NJ: High variability of femoral rotational alignment in total knee arthroplasty. Journal of Bone and Joint Surgery 2005 87-A:2276-2280 Siston RA, Giori NJ, Goodman SB, Delp SL: Intraoperative Passive Kinematics of Osteoarthritic Knees Before and After Total Knee Arthroplasty. Journal of Orthopedic Research 2006 24(8):1607-1614. Siston RA, Goodman SB, Patel JJ, Delp SL, Giori NJ: The high variability of tibial component rotational alignment in total knee arthroplasty. Clin Orthop 2006 Nov;452:65-69. Siston RA, Giori NJ, Goodman SB, Delp SL: Surgical navigation for total knee arthroplasty: A perspective. J Biomech 2007;40(4):728-735. Funding Source: No outside funding
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