Evaluation of Soft-Tissue Balance during Total Knee Arthroplasty

Sasanuma, Hideyuki; Sekiya, Hiroo; Takatoku, Kenzo; Takada, Hisashi; Sugimoto, Naoya

doi:10.1177/230949901001800106

Cited by 31 publications

(20 citation statements)

References 20 publications

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“…Sekiya et al [23] suggested that postoperative lateral ligamentous laxity diminished with time, reporting that 8.6°of lateral laxity at extension diminished to 5.1°3 months after TKA. We think it is unnecessary to release ligaments too much on the medial side to be the same length with the loose lateral side and accept a slight intraoperative lateral laxity as long as a neutral coronal alignment can be achieved after implantation [6,19,21]. When taking into account the resected bone, we found the lateral soft tissue was more lax but the medial soft tissue was not shorter with greater varus deformity.…”

Section: Discussionmentioning

confidence: 80%

Lateral Soft Tissue Laxity Increases but Medial Laxity Does Not Contract With Varus Deformity in Total Knee Arthroplasty

Okamoto

Okazaki

Mitsuyasu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Section: Discussionmentioning

confidence: 80%

Lateral Soft Tissue Laxity Increases but Medial Laxity Does Not Contract With Varus Deformity in Total Knee Arthroplasty

Okamoto

Okazaki

Mitsuyasu

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…The technique involved inserting a commercial tensor device (Stryker Howmedica Osteonics Corp, Allendale, NJ, USA) with the knee in extension as described by Winemaker and others [3,46,47,58]. The surgeon measured the medial and lateral gaps and made releases as needed to achieve equal medial and lateral gaps to within ± 2 mm.…”

Section: Methodsmentioning

confidence: 99%

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

Song

Seon

Yim

et al. 2013

Clinical Orthopaedics &Amp; Related Research

333

295

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Background Several studies have shown mechanical alignment influences the outcome of TKA. Robotic systems have been developed to improve the precision and accuracy of achieving component position and mechanical alignment. Questions/purposes We determined whether roboticassisted implantation for TKA (1) improved clinical outcome; (2) improved mechanical axis alignment and implant inclination in the coronal and sagittal planes; (3) improved the balance (flexion and extension gaps); and (4) reduced complications, postoperative drainage, and operative time when compared to conventionally implanted TKA over an intermediate-term (minimum 3-year) followup period. MethodsWe prospectively randomized 100 patients who underwent unilateral TKA into one of two groups: 50 using a robotic-assisted procedure and 50 using conventional manual techniques. Outcome variables considered were postoperative ROM, WOMAC scores, Hospital for Special Surgery (HSS) knee scores, mechanical axis alignment, flexion/extension gap balance, complications, postoperative drainage, and operative time. Minimum followup was 41 months (mean, 65 months; range, 41-81 months). Results There were no differences in postoperative ROM, WOMAC scores, and HSS knee scores. The roboticassisted group resulted in no mechanical axis outliers ([ ± 3°from neutral) compared to 24% in the conventional group. There were fewer robotic-assisted knees

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“…A commercial tensor device (Stryker Howmedica Osteonics Corp., Allendale, NJ, USA) was inserted with the knee in extension as described in previous studies 15192021). The medial and lateral gaps were measured, and required release was done to produce within ± 2 mm of medial-lateral gap difference.…”

Section: Methodsmentioning

confidence: 99%

Robotic Total Knee Arthroplasty with a Cruciate-Retaining Implant: A 10-Year Follow-up Study

et al. 2017

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BackgroundThis study compared clinical and radiological results between robotic total knee arthroplasty (TKA) and conventional TKA with a cruciate-retaining implant at 10-year follow-up. The hypothesis was that robotic TKA would allow for more accurate leg alignment and component placement, and thus enhance clinical and radiological results and long-term survival rates.MethodsA total of 113 primary TKAs performed using a cruciate-retaining implant in 102 patients from 2004 to 2007 were reviewed retrospectively. Of the 113 TKAs, 71 were robotic TKAs and 42 were conventional TKAs. Clinical outcomes (visual analogue scale pain score, Hospital for Special Surgery score, Western Ontario and McMaster University score, range of motion, and complications), radiological outcomes, and long-term survival rates were evaluated at a mean follow-up of 10 years.ResultsClinical outcomes and long-term survival rates were similar between the two groups. Regarding the radiological outcomes, the robotic TKA group had significantly fewer postoperative leg alignment outliers (femoral coronal inclination, tibial coronal inclination, femoral sagittal inclination, tibial sagittal inclination, and mechanical axis) and fewer radiolucent lines than the conventional TKA group.ConclusionsBoth robotic and conventional TKAs resulted in good clinical outcomes and postoperative leg alignments. Robotic TKA appeared to reduce the incidence of leg alignment outliers and radiolucent lines compared to conventional TKA.

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Evaluation of Soft-Tissue Balance during Total Knee Arthroplasty

Abstract: Slightly greater lateral laxity was observed after TKA, although equal medial-lateral balance was achieved intra-operatively.

Cited by 31 publications

References 20 publications

Lateral Soft Tissue Laxity Increases but Medial Laxity Does Not Contract With Varus Deformity in Total Knee Arthroplasty

Lateral Soft Tissue Laxity Increases but Medial Laxity Does Not Contract With Varus Deformity in Total Knee Arthroplasty

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

Robotic Total Knee Arthroplasty with a Cruciate-Retaining Implant: A 10-Year Follow-up Study

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