Soft tissue balance is an essential step in total knee arthroplasty by providing a good knee stability and an even distribution of load over the prosthesis components. During surgery, because of the need of having a good balance in most cases is necessary to do some soft tissue release in the medial compartment. Lateral release is far more rare and is generally needed for patients with valgus knees after high tibial osteotomy. Our purpose is to evaluate the complications that arise during soft tissue release and how to manage this unfortunate events for getting the best functional results for the patients. In this study, we analyzed 434 knee arthroplasties that were operated in our clinic in the past 8 years by the same knee team (2005-2012). Average age was 64.8 years. Eight of this patients had medial collateral ligament injuries during surgery, and two had lateral collateral ligament rupture. Average age of patients who suffered from medial collateral ligaments injuries was 62.8 years and for lateral collateral ligaments was 72.5 years. Body mass index was 34 for both groups. We used for evaluation the knee society pain and functional scores, and X-rays obtained after the surgery with a calibrated Siemens machine. Seven patients with MCL repair were satisfied with after surgery (Knee Society score was 87.7, and functional score was 80). One complained of knee instability associated with pain and needed revision. In LCL group, all patients had excellent results (Knee Society score was 91.5, and functional score was 85). We found that repair to collateral ligaments injuries must be obtained during surgery, especially complete ruptures of the MCL. There are several approaches to collateral ligaments ruptures during total knee arthroplasty that will be discussed during the article.
Carbon fiber reinforced -polyetheretherketone CoCrMo -Cobalt Chromium Molybdenum CR-Cruciate-retaining CT -Computer Tomograph FE -Finite element FEM -Finite element method PEEK -Polyetheretherketone SS 316 L -Stainless steel Ti6Al4V -Alpha-beta titanium TKA -Total knee arthroplasty UMWPE -Ultrahigh molecular weight polyethylene www.revistachirurgia.ro Chirurgia, 114 (4), 2019biomecanicii genunchiului supus diferitelor sarcini. Metoda elementului finit este folosită pentru a reduce incidenţa reviziei şi a îmbunătăţi satisfacţia pacienţilor după artroplastia totală de genunchi.Cuvinte cheie: metoda elementului finit, artroplastia totală de genunchi, uzura polietilenei, satisfacţie pacient
Total knee arthroplasty surgery is a current practice in orthopedic surgery. The success of this intervention consists in part in the realignment of the lower extremity's anatomical axis, adequate implant orientation and design, good implant fixation, proper soft tissue balancing, and stability. A good exposure also allows optimal placement of the components. Our preferred approach is the median parapatellar approach in most cases. However, the orthopedic surgeon may face anatomical variants associated with knee types that may complicate the classic approach. We are reviewing multiple surgical approaches also used by us in our clinic in total knee arthroplasty, as well as additional techniques in these surgical approaches. The MIS approach can be used in many cases to reduce pain and speed the healing process. All of the total knee arthroplasty approaches are detailed with anatomical illustrations along with advantages and disadvantages of each. The ultimate goal is to restore knee function as quickly as possible and to preserve the anatomical integrity of the joint.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.