Soft Tissue Balance Changes Depending on Joint Distraction Force in Total Knee Arthroplasty

Nagai, Kazuo; Muratsu, Hirotsugu; Matsumoto, Tomoyuki; Miya, Hidetoshi; Kuroda, Ryosuke; Kurosaka, Masahiro

doi:10.1016/j.arth.2013.07.025

Cited by 55 publications

(43 citation statements)

References 12 publications

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“…However, no study has demonstrated a significant improvement of patient satisfaction after TKA with these devices [43][44][45]. Nagai et al reported that the medial compartment was always stiffer than the lateral structure at all flexion angles from 0 • to 135 • [46]. Nevertheless, the appropriate loads are defined mainly with arbitrary limits.…”

Section: Advantages and Limitationsmentioning

confidence: 99%

New Technologies in Knee Arthroplasty: Current Concepts

Batailler

Swan

Sappey‐Marinier

et al. 2020

JCM

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Total knee arthroplasty (TKA) is an effective treatment for severe osteoarthritis. Despite good survival rates, up to 20% of TKA patients remain dissatisfied. Recently, promising new technologies have been developed in knee arthroplasty, and could improve the functional outcomes. The aim of this paper was to present some new technologies in TKA, their current concepts, their advantages, and limitations. The patient-specific instrumentations can allow an improvement of implant positioning and limb alignment, but no difference is found for functional outcomes. The customized implants are conceived to reproduce the native knee anatomy and to reproduce its biomechanics. The sensors have to aim to give objective data on ligaments balancing during TKA. Few studies are published on the results at mid-term of these two devices currently. The accelerometers are smart tools developed to improve the TKA alignment. Their benefits remain yet controversial. The robotic-assisted systems allow an accurate and reproducible bone preparation due to a robotic interface, with a 3D surgical planning, based on preoperative 3D imaging or not. This promising system, nevertheless, has some limits. The new technologies in TKA are very attractive and have constantly evolved. Nevertheless, some limitations persist and could be improved by artificial intelligence and predictive modeling.

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Section: Advantages and Limitationsmentioning

confidence: 99%

New Technologies in Knee Arthroplasty: Current Concepts

Batailler

Swan

Sappey‐Marinier

et al. 2020

JCM

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“…This device was designed to permit surgeons to measure ligament balance (varus angle) and joint center gap (joint component gap), both before and after femoral trial prosthesis placement, under a constant joint distraction force [7,15]. Joint distraction forces ranging from 20 lbs.…”

Section: Methodsmentioning

confidence: 99%

Effect of intraoperative soft tissue balance on postoperative recovery of ambulatory and balancing function in posterior-stabilized total knee arthroplasty

Tsubosaka

Muratsu²,

Takayama

et al. 2019

Journal of Orthopaedic Science

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Background: The effectiveness of total knee arthroplasty (TKA) on ambulatory and balancing function recovery should be quantitatively investigated. The present study aimed to evaluate ambulatory function using 3m-timed up and go (TUG) test and balancing function using one-leg standing time (ST) from before and after TKA, and to analyze the effects of intraoperative soft tissue balance on the postoperative improvement of their functions after TKA. Methods: The study included 65 patients with varus-type knee osteoarthritis who underwent primary posterior-stabilized (PS) TKA. The TUG test and ST were performed preoperatively, 1 month and 12 months after TKA. The intraoperative soft tissue balance, medial and lateral joint looseness (MJL, LJL) were evaluated with both femoral trial in place and patellofemoral joint reduced using the OFR tensor® with the knee at 0, 10, 30, 45, 60, 90, 120, and 135°. The influences of MJL and LJL on the improvement in TUG test time and ST and the 2011 Knee Society Knee Scoring System (2011 KSS) 12 months 3 after TKA were investigated. Results: The mean TUG test times and ST were 12.7 and 13.1, 13.5 and 15.4, and 10.9 and 19.2 seconds preoperatively, 1 month and 12 months after TKA, respectively. The MJL at 10, 30 and 90° flexion was significantly negatively correlated with improvement in the TUG test time and the MJL at 0° flexion was significantly negatively correlated with improvement in the ST. However, the LJL was not significantly correlated with improvement in the TUG test time and the ST. The MJL at 45, 60, and 90° flexion was significantly negatively correlated with the 12-month postoperative score on the activities subscale of the 2011 KSS. Conclusions: The higher intraoperative medial knee stability may be associated with the better postoperative improvement in ambulatory function and activities subscale of the 2011 KSS after PS-TKA.

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“…Even though a large amount of studies have expounded the indispensable part of soft tissue releases, the aim of this study was to illustrate the surgical technique for TKA without soft tissue release which could make good prognosis.…”

Section: Introductionmentioning

confidence: 99%

Surgical Technique of Total Knee Arthroplasty without Soft Tissue Balance

Dong

Wang

et al. 2016

Orthopaedic Surgery

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Total knee arthroplasty (TKA) without soft tissue balance can create a balanced knee to a mechanical axis of near neutral with bone cuts, and remove osteophytes thoroughly. In this study, the authors present detailed steps for performing TKA. The attached video demonstrates the TKA procedure. The patient is a 77-year-old man who had suffered from knee pain for 12 years. Physical examination showed the Apley test to be positive and that the range of motion (ROM) decreased. An X-ray filmed at the positive lateral of the knee joint and the double lower extremity revealed a progression of degenerative osteoarthritis with genu varum. The key point of no soft tissue release is to make a rectangular extensional space by osteotomy. In addition, the osteophytes, especially syndesmophytes, should be removed thoroughly. As a result, the ligaments can achieve ideal length and the flexion contracture can also be remedied. Moreover, in surgeries without soft tissue release, bone mass and normal tissue are retained. Patients are satisfied to the surgery not only with less blood loss, anterior knee pain and DVT, but also faster rehabilitation. In summary, TKA without soft tissue balance is an efficient procedure for patients with knee osteoarthritis which can result in good prognosis.

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Soft Tissue Balance Changes Depending on Joint Distraction Force in Total Knee Arthroplasty

Cited by 55 publications

References 12 publications

New Technologies in Knee Arthroplasty: Current Concepts

New Technologies in Knee Arthroplasty: Current Concepts

Effect of intraoperative soft tissue balance on postoperative recovery of ambulatory and balancing function in posterior-stabilized total knee arthroplasty

Surgical Technique of Total Knee Arthroplasty without Soft Tissue Balance

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