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  • Journal article
    Tuncer M, Patel R, Cobb JP, Hansen UN, Amis AAet al., 2015,

    Variable bone mineral density reductions post-unicompartmental knee arthroplasty

    , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 23, Pages: 2230-2236, ISSN: 0942-2056
  • Journal article
    Kittl C, Schmeling A, Amis AA, 2015,

    The patellofemoral joint. Anatomy, biomechanics, and surgical interventions

    , ARTHROSKOPIE, Vol: 28, Pages: 172-180, ISSN: 0933-7946
  • Journal article
    Halewood C, Traynor A, Bellemans J, Victor J, Amis AAet al., 2015,

    Anteroposterior Laxity After Bicruciate-Retaining Total Knee Arthroplasty Is Closer to the Native Knee Than ACL-Resecting TKA: A Biomechanical Cadaver Study.

    , Journal of Arthroplasty, ISSN: 1532-8406

    The purpose of this study was to examine whether a bicruciate retaining (BCR) TKA would yield anteroposterior (AP) laxity closer to the native knee than a posterior cruciate ligament retaining (CR) TKA. A BCR TKA was designed and compared to CR TKA and the native knee using cadaver specimens. AP laxity with the CR TKA was greater than the native knee (P=0.006) and BCR TKA (P=0.039), but no difference was found between the BCR TKA and the native knee. No significant differences were found in rotations between the prostheses and the native knee. BCR TKA was shown to be surgically feasible, reduced AP laxity versus CR TKA, and may improve knee stability without using conforming geometry in the implant design.

  • Journal article
    Ghosh KM, Hunt N, Blain A, Athwal KK, Longstaff L, Amis AA, Rushton S, Deehan DJet al., 2015,

    Isolated popliteus tendon injury does not lead to abnormal laxity in posterior-stabilised total knee arthroplasty

    , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 23, Pages: 1763-1769, ISSN: 0942-2056
  • Journal article
    Hansen UN, sukjamsri, amis, 2015,

    Digital volumecorrelationandmicro-CT:Anin-vitrotechniquefor measuringfull-field interfacemicromotionaroundpolyethyleneimplants

    , Journal of Biomechanics, ISSN: 1873-2380
  • Book chapter
    Halewood C, Masouros S, Amis AA, 2015,

    Structure and function of the menisci

    , Meniscal Allograft Transplantation. A comprehensive review., Editors: Getgood, Spalding, Cole, Gersoff, Verdonk, ISBN: 978-0-9558873-5-2
  • Book chapter
    Halewood C, Lumpaopong P, Stephen JM, Amis AAet al., 2015,

    Functional Biomechanics with Cadaver Specimens

    , Experimental Research Methods in Orthopedics and Trauma, Editors: Simpson, Augat, Publisher: Thieme Medical Publishers, ISBN: 9783131731111

    This book provides a comprehensive summary of all current research methodologies for translational and pre-clinical studies in biomechanics and orthopedic trauma surgery.

  • Journal article
    Halewood C, Amis AA, 2015,

    Clinically relevant biomechanics of the knee capsule and ligaments

    , Knee Surgery, Sports Traumatology, Arthroscopy, Vol: 23, Pages: 2789-2796, ISSN: 0942-2056

    The paper describes the concepts of primary and secondary restraints to knee joint stability and explains systematically how the tibia is stabilised against translational forces and rotational torques in different directions and axes, and how those vary across the arc of flexion–extension. It also shows how the menisci act to stabilise the knee, in addition to load carrying across the joint. It compares the properties of the natural stabilising structures with the strength and stiffness of autogenous tissue grafts and relates those strengths to the strength of graft fixation devices. A good understanding of the biomechanical behaviour of these various structures in the knee will help the surgeon in the assessment and treatment of single and multi-ligament injuries.

  • Journal article
    van Arkel RJ, Amis AA, Cobb JP, Jeffers JRTet al., 2015,

    The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres

    , Bone & Joint Journal, Vol: 97B, Pages: 484-491, ISSN: 2049-4394

    In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty.

  • Conference paper
    Stephen JM, Halewood C, Kittl C, Bollen S, Williams A, Amis AAet al., 2015,

    The influence of posterior medial meniscocapsular lesions on tibiofemoral joint laxity in ACL deficient and reconstructed knees

    , British Association of Surgery of the Knee
  • Conference paper
    Halewood C, 2015,

    Anteroposterior laxity after bicruciate-retaining total knee replacement is closer to the intact knee than conventional ACL-resecting TKR: a biomechanical cadaver study

    , BASK
  • Journal article
    Kawaguchi Y, Kondo E, Takeda R, Akita K, Yasuda K, Amis AAet al., 2015,

    The role of fibers in the femoral attachment of the anterior cruciate ligament in resisting tibial displacement


    PurposeThe purpose was to clarify the load-bearing functions of the fibers of the femoral anterior cruciate ligament (ACL) attachment in resisting tibial anterior drawer and rotation.MethodsA sequential cutting study was performed on 8 fresh-frozen human knees. The femoral attachment of the ACL was divided into a central area that had dense fibers inserting directly into the femur and anterior and posterior fan-like extension areas. The ACL fibers were cut sequentially from the bone: the posterior fan-like area in 2 stages, the central dense area in 4 stages, and then the anterior fan-like area in 2 stages. Each knee was mounted in a robotic joint testing system that applied tibial anteroposterior 6-mm translations and 10° or 15° of internal rotation at 0° to 90° of flexion. The reduction of restraining force or moment was measured after each cut.ResultsThe central area resisted 82% to 90% of the anterior drawer force; the anterior fan-like area, 2% to 3%; and the posterior fan-like area, 11% to 15%. Among the 4 central areas, most load was carried close to the roof of the intercondylar notch: the anteromedial bundle resisted 66% to 84% of the force and the posterolateral bundle resisted 16% to 9% from 0° to 90° of flexion. There was no clear pattern for tibial internal rotation, with the load shared among the posterodistal and central areas near extension and mostly the central areas in flexion.ConclusionsUnder the experimental conditions described, 66% to 84% of the resistance to tibial anterior drawer arose from the ACL fibers at the central-proximal area of the femoral attachment, corresponding to the anteromedial bundle; the fan-like extension fibers contributed very little. This work did not support moving a single-bundle ACL graft to the side wall of the notch or attempting to cover the whole attachment area if the intention was to mimic how the natural ACL resists tibial displacements.Clinical RelevanceThere is ongoing debate about ho

  • Journal article
    Kittl C, Halewood C, Stephen JM, Gupte CM, Weiler A, Williams A, Amis AAet al., 2015,

    Length change patterns in the lateral extra-articular structures of the knee and related reconstructions

    , American Journal of Sports Medicine, Vol: 43, Pages: 354-362, ISSN: 0363-5465

    Background:Lateral extra-articular soft tissue reconstructions in the knee may be used as a combined procedure in revision anterior cruciate ligament surgery as well as in primary treatment for patients who demonstrate excessive anterolateral rotatory instability. Only a few studies examining length change patterns and isometry in lateral extra-articular reconstructions have been published.Purpose:To determine a recommended femoral insertion area and graft path for lateral extra-articular reconstructions by measuring length change patterns through a range of knee flexion angles of several combinations of tibial and femoral insertion points on the lateral side of the knee.Study Design:Controlled laboratory study.Methods:Eight fresh-frozen cadaveric knees were freed of skin and subcutaneous fat. The knee was then mounted in a kinematics rig that loaded the quadriceps muscles and simulated open-chain knee flexion. The length changes of several combinations of tibiofemoral points were measured at knee flexion angles between 0° and 90° by use of linear variable displacement transducers. The changes in length relative to the 0° measurement were recorded.Results:The anterior fiber region of the iliotibial tract displayed a significantly different (P < .001) length change pattern compared with the posterior fiber region. The reconstructions that had a femoral insertion site located proximal to the lateral epicondyle and with the grafts passed deep to the lateral collateral ligament displayed similar length change patterns to each other, with small length increases during knee extension. These reconstructions also showed a significantly lower total strain range compared with the reconstruction located anterior to the epicondyle (P < .001).Conclusion:These findings show that the selection of graft attachment points and graft course affects length change pattern during knee flexion. A graft attached proximal to the lateral femoral epicondyle and running deep

  • Conference paper
    Stephen JM, Kittl C, Williams A, Marcheggiani Muccioli GM, Zaffagnini S, Fink C, Amis AAet al., 2015,

    The effect of graft type and femoral positioning on patellofemoral contact pressure and kinematics after medial patellofemoral ligament reconstruction

    , British Association for Surgery of the Knee
  • Conference paper
    Geraldes D, Hansen U, Amis A, 2015,

    Parametric analysis of glenoid implant design

    , European Society of Biomechanics 2015
  • Book chapter
    Keller R, Amis AA, 2015,

    Anatomy and Biomechanics of the Natural Knee and After TKR

    , The Unhappy Total Knee Replacement, Editors: Hirschmann, Becker, Publisher: Springer, Pages: 3-15, ISBN: 978-3-319-08098-7

    This book addresses the need for improved diagnostic and treatment guidelines for patients in whom total knee arthroplasty (TKA) has had an unsatisfactory outcome. It opens by discussing the basics of TKA and the various causes of failure and pain. Diagnostic aspects are considered in detail, with attention to advances in clinical investigation, laboratory analysis and in particular, imaging techniques. In addition, helpful state of the art diagnostic algorithms are presented. Specific pathology-related treatment options, including conservative approaches and salvage and revision TKA strategies, are then explained, with identification of pitfalls and key points. A series of illustrative cases cover clinical scenarios frequently encountered in daily clinical practice. The evidence-based, clinically focused guidance provided in this book, written by internationally renowned experts, will assist surgeons in achieving the most effective management of these challenging cases.

  • Journal article
    Hunt NC, Ghosh KM, Athwal KK, Longstaff LM, Amis AA, Deehan DJet al., 2014,

    Lack of evidence to support present medial release methods in total knee arthroplasty

    , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 22, Pages: 3100-3112, ISSN: 0942-2056
  • Journal article
    Halewood C, Risebury M, Thomas NP, Amis AAet al., 2014,

    Kinematic behaviour and soft tissue management in guided motion total knee replacement

    , KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol: 22, Pages: 3074-3082, ISSN: 0942-2056
  • Conference paper
    Geraldes D, Hansen U, Amis A, 2014,

    A framework for parametric analysis of glenoid implant design

    , MECBioengineering 2014
  • Conference paper
    Sukjamsri C, Geraldes D, Gregory T, Hansen Uet al., 2014,

    Micro computed tomography and digital volume correlation techniques to determine micromotion in cementless arthroplasty

    , World Congress of Biomechanics 2014

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