An Intraoperative Pressure-Measuring Device Used in Total Knee Arthroplasties and Its Kinematics Correlations

Lack of Axial Rotation in Mobile-bearing Knee Designs

“…These variable results suggest that although certain designs may be more surgeon-friendly, the surgeon factors affecting femorotibial rotation need to be more fully understood. Wasielewski et al [23] studied the influence of surgical factors on knee kinematics using an intraoperative pressure-measuring device on the insert trial. In 16 patients with well-balanced knees, they reported only three occurrences of major condylar liftoff (defined as condylar tibial separation 1 mm or greater) but poor translation and axial rotation (average, 2.4°).…”

How are we addressing ligament balance in TKA? A literature review of revision etiology and technological advancement

“…This enables the surgeon to receive real-time feedback of component positioning and torque, adjusting any imbalance with additional bony resection or soft-tissue corrections. 62,63 Wasielewski et al reported on the first smart tibial trial in 2004 and determined that intraoperative sensors displayed greater sensitivity and were able to detect sublinical compartment abnormalities that were not detected by the surgeon's feel. 62,63 The majority of these subclinical abnormalities occurred in flexion, where variables such as leg size and the surgeon's ability to stabilize the knee can make a qualitative assessment of balance difficult.…”

“…62,63 Wasielewski et al reported on the first smart tibial trial in 2004 and determined that intraoperative sensors displayed greater sensitivity and were able to detect sublinical compartment abnormalities that were not detected by the surgeon's feel. 62,63 The majority of these subclinical abnormalities occurred in flexion, where variables such as leg size and the surgeon's ability to stabilize the knee can make a qualitative assessment of balance difficult. 62 Disposable and intended for single use, this technology is relatively inexpensive at less than $1000 USD per case.…”

“…62,63 The majority of these subclinical abnormalities occurred in flexion, where variables such as leg size and the surgeon's ability to stabilize the knee can make a qualitative assessment of balance difficult. 62 Disposable and intended for single use, this technology is relatively inexpensive at less than $1000 USD per case. 64 In addition, because the sensors are embedded in the tibial trial there are no supplementary operative steps and therefore no disruption in workflow.…”

“…21 The greatest limitation of this technology includes the fact that measured pressures and load are detected in an open-chain, non weight-bearing state without surrounding muscle contraction. [62][63][64] Soft-tissue balance is likely variable with weight-bearing activities, so the use of intra-operative sensors may serve as a relative rather than absolute measurement of joint balance until further analysis is completed. [62][63][64] There is limited research regarding the use of sensor-assisted TKA, however nearly all of the research depicts favorable outcomes.…”