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In order to facilitate the technology transfer to managers and technicians, free software (DOP, "Diseño Optimo de Pivotes," or Optimal Pivot Design) has been developed using MATLAB™.
Spherical pivot design produced invariant characteristics with varying misalignment ratio and phase, whereas the cylindrical pivot showed noticeable variation.
To assess whether there the final range of motion (ROM) results achieved by patients undergoing total knee arthroplasty (TKA) with prosthesis using Medial Pivot design are predictable.
All patients with a Freeman-Samuelson 1000 knee arthroplasty (medial pivot design), (group 1), or a Freeman-Samuelson Modular knee arthroplasty, (group 2), with a minimum follow-up of 2 years (mean follow-up 4 years) were identified from our unit's arthroplasty database, and matched as closely as possible for age, length of follow-up and pre-operative diagnosis.
For the pilot surveys, a pivot design, minimising D-error (a measure of efficiency) was generated using priors of zero for the marginal utility of all attributes.
Patient dissatisfaction in the Medial Pivot design was skewed by the infected prostheses, and it is not difficult to believe that the presence of recurrent effusions in nine of these patients indicates that the infection actually persists, as might the residual flexion contracture in three knees.
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A slightly asymmetric soft tissue balancing is mandatory using medial pivot designs to obtain a correct and physiological knee biomechanics leading good outcomes and long survival rates.
The study relies on a pen-and-paper survey (1010 completed survey forms with 2023 reported trips) which uses a stated-preference pivoting design to build hypothetical choice sets around actual trips.
Theoretically, the medial-pivot design provides a large contact area in the medial compartment and lower contact stresses, which should result in lower insert wear.
The medial-pivot design features an asymmetrical tibial insert that controls the anterior-posterior translation of the femur in the medial compartment, while allowing unrestricted movement of the femur in the lateral compartment.
The medial pivot prosthesis design provides anteroposterior stability during demanding activities, and exhibits a medial pivot motion pattern when subjected to twisting.
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