Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique View Full Text


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Article Info

DATE

2013-10-22

AUTHORS

Tomoyuki Matsumoto, Hirotsugu Muratsu, Yohei Kawakami, Koji Takayama, Kazunari Ishida, Takehiko Matsushita, Toshihiro Akisue, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka

ABSTRACT

PurposeThe purpose of this study was to prove the hypothesis that soft tissues are well balanced using the gap technique with a navigation system in cruciate-retaining (CR) and posterior-stabilised (PS) total knee arthroplasty (TKA), leading to better clinical outcomes compared with the measured-resection technique.MethodsOne hundred and thirty-five TKAs (90 CR and 45 PS) were performed in patients with varus-type osteoarthritis using the gap technique guided by the offset-type tensor and a navigation system. Soft-tissue balance (joint-component gap and ligament balance) were intraoperatively assessed with the tensor under 40 lb of joint-distraction force. The achievement in the equalised rectangular gap at extension and flexion was assessed and retrospectively compared with the previous series in which the measured-resection technique was used (20 CR and 100 PS TKAs). In addition, clinical outcomes, including range of motion and Knee Society Score were assessed at a minimum two year follow-up.ResultsIn achieving equalised rectangular gaps at extension and flexion, CR TKAs met criteria in more cases [66.7 % (64/90) vs. 44.4 % (20/45) of PS TKA] with the gap technique, which was superior to that with the measured-resection technique [50.0 % (10/20) of CR TKA and 28.0 % (28/100) of PS TKA]. However, clinical outcomes showed no significant differences among groups at minimum two year follow-up.ConclusionsThe superiority of CR TKA with the gap technique in achieving equalised rectangular gaps at extension and flexion does not directly reflect two year postoperative clinical outcomes. More... »

PAGES

531-537

References to SciGraph publications

  • 2011-02-08. The impact of a rectangular or trapezoidal flexion gap on the femoral component rotation in TKA in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-10-22. The Role of Polyethylene Design on Postoperative TKA Flexion: An Analysis of 1534 Cases in CLINICAL ORTHOPAEDICS AND RELATED RESEARCH®
  • 2009-11-19. Accuracy of soft tissue balancing in TKA: comparison between navigation-assisted gap balancing and conventional measured resection in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-02-18. Comparisons of kinematics and range of motion in high-flexion total knee arthroplasty: cruciate retaining vs. substituting designs in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2008-10-28. Is referencing the posterior condyles sufficient to achieve a rectangular flexion gap in total knee arthroplasty? in INTERNATIONAL ORTHOPAEDICS
  • 2010-04-14. Comparison between two computer-assisted total knee arthroplasty: gap-balancing versus measured resection technique in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2013-03-05. Kinematic factors affecting postoperative knee flexion after cruciate-retaining total knee arthroplasty in INTERNATIONAL ORTHOPAEDICS
  • 2012-05-30. Significant effect of the posterior tibial slope and medial/lateral ligament balance on knee flexion in total knee arthroplasty in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-10-27. Soft tissue balance using the tibia first gap technique with navigation system in cruciate-retaining total knee arthroplasty in INTERNATIONAL ORTHOPAEDICS
  • 2011-03-23. Comparison of joint line position changes after primary bilateral total knee arthroplasty performed using the navigation-assisted measured gap resection or gap balancing techniques in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00264-013-2133-9

    DOI

    http://dx.doi.org/10.1007/s00264-013-2133-9

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1046762048

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24146174


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    35 schema:description PurposeThe purpose of this study was to prove the hypothesis that soft tissues are well balanced using the gap technique with a navigation system in cruciate-retaining (CR) and posterior-stabilised (PS) total knee arthroplasty (TKA), leading to better clinical outcomes compared with the measured-resection technique.MethodsOne hundred and thirty-five TKAs (90 CR and 45 PS) were performed in patients with varus-type osteoarthritis using the gap technique guided by the offset-type tensor and a navigation system. Soft-tissue balance (joint-component gap and ligament balance) were intraoperatively assessed with the tensor under 40 lb of joint-distraction force. The achievement in the equalised rectangular gap at extension and flexion was assessed and retrospectively compared with the previous series in which the measured-resection technique was used (20 CR and 100 PS TKAs). In addition, clinical outcomes, including range of motion and Knee Society Score were assessed at a minimum two year follow-up.ResultsIn achieving equalised rectangular gaps at extension and flexion, CR TKAs met criteria in more cases [66.7 % (64/90) vs. 44.4 % (20/45) of PS TKA] with the gap technique, which was superior to that with the measured-resection technique [50.0 % (10/20) of CR TKA and 28.0 % (28/100) of PS TKA]. However, clinical outcomes showed no significant differences among groups at minimum two year follow-up.ConclusionsThe superiority of CR TKA with the gap technique in achieving equalised rectangular gaps at extension and flexion does not directly reflect two year postoperative clinical outcomes.
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