Effect of Posterior Osteophytes on Total Knee Arthroplasty Coronal Soft Tissue Balance: Do They Matter?

Gustke, K A; Cherian, Jeffrey J.; Simon, Péter; Morrison, Todd A.

doi:10.1016/j.arth.2022.01.034

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…Unlike our study, these two studies showed that removal caused a greater increase in the flexion gap, while neither of these studies analysed the results according to osteophyte size. Gustke et al [ 19 ] demonstrated the effect of posterior osteophytes on the size and location by measuring gaps using a robot-assisted system. In contrast to previous studies, no significant differences were observed, regardless of the presence of osteophytes.…”

Section: Discussionmentioning

confidence: 99%

Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing

Lee,

Jung,

Lee

et al. 2023

JCM

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Robotic arm–assisted total knee arthroplasty (TKA) involves a pre-resection gap balancing technique to obtain the desired gap. However, the expected gap may change owing to the soft-tissue release effect of unreachable osteophytes. This study evaluated the effect of unreachable osteophytes of the posterior medial femoral condyle on gap changes following bony resection. We retrospectively analysed 129 robotic arm–assisted TKAs performed for varus knee osteoarthritis. Knees were classified according to the size of osteophytes on the posterior medial femoral condyle using preoperative computed tomography measurement. After the removal of reachable osteophytes, the robotic system measured pre- and post-resection medial extension (ME), lateral extension (LE), medial flexion (MF), and lateral flexion (LF) gaps. No extension gap changes were observed for 25 (19.4%), and no flexion gap changes were observed 41 (31.8%) knees, following bone cuts. ME, LE, MF, and LF gaps increased with the osteophyte size (p < 0.05). For osteophytes <10 mm, all the gaps increased symmetrically. However, for osteophytes >10 mm, the ME gap increased asymmetrically more than LE, MF, and LF gaps (p < 0.05). The gap changes due to bony resection were correlated to the osteophyte sizes of the posterior medial femoral condyle. Surgeons should plan a slightly tight medial extension gap to attain the desired gaps for >10 mm osteophytes.

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Section: Discussionmentioning

confidence: 99%

Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing

Lee,

Jung,

Lee

et al. 2023

JCM

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“…Literature was used to determine the parameters related to the anatomical aspect, surface and grade of osteophytes (A. E. Van der Merwe, 2006;Gustke, Cherian, Simon, & Morrison, 2022;TÜMERDEM, 2006). Length measurements were determined according to the measurements made in the AKGÜN PACS program.…”

Section: Methodsmentioning

confidence: 99%

Anatomical and epidemiological examination of the structure and localization of osteophytes of cervical vertebrae in geriatric patients by using computed tomography method

NİŞANCI

Ozyurt

2023

Journal of Medical Topics and Updates

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Background: To evaluate the osteophytes seen in the cervical vertebrae of geriatric individuals in various parameters. Materials and Methods: 764 (M: 413, F: 351) individuals who were admitted to the State Hospital Radiology Outpatient Clinic with various complaints between the years 2018 and 2023 and who met the criteria were examined in our study. A total of 1209 osteophytes were found in the individuals. The osteophytes were evaluated in terms of gender, age, grade, vertebral level, vertebral spacing, anatomical aspect, anatomical surface and length parameters. Results: Osteophyte formation increased with age in individuals (p0.05). Claw type osteophytes were observed commonly in all individuals (p

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“…Of note, a knee flexion contracture, defined as an inability to passively extend the knee fully to 0°, persists in 2.9−28% of patients post TKA, causing knee‐related disability and dissatisfaction making it a significant issue to be resolved [13, 25, 28]. For patients with an intraoperative knee flexion contracture, resection of osteophytes and/or posterior capsular release are feasible procedures to minimize the risk of persistent postoperative contracture [9, 23]. However, determining the risk for persistent knee joint flexion contracture prior to surgery is challenging as risk factors remain to be identified.…”

Section: Introductionmentioning

confidence: 99%

The significance of the pelvic incidence measurement as a possible predictor of TKA outcome

Okamoto

Wakama

Matsuyama

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the association between the sagittal alignment of the pelvis and residual knee lexion contracture after total knee arthroplasty (TKA). This is important as a lexion contraction can be associated with the risk of poor outcomes and patient satisfaction after TKA. Methods This was a retrospective, case-control, study of 200 osteoarthritic knees, contributed by 200 patients, over a mean follow-up of 2.4 years. The following factors were compared between patients 'with' (46 knees) and 'without' (154 knees) a residual lexion contracture ≥ 10° after TKA: age, sex, pelvic incidence (PI), anterior femoral bowing, femoral component lexion angle (FFA), and patient-reported outcomes. Logistic regression and receiver operating characteristic curve analyses were used to identify predictive factors. ResultsThe following factors were predictive of a residual lexion contracture ≥ 10°: a pelvic incidence ≥ 55° (odds ratio, 1.29; 95% conidence interval, 1.05−1.59; P = 0.031) and the FFA (odds ratio, 1.08; 95% conidence interval, 1.03−1.14; P = 0.044). A pelvic incidence cutof of 55° yielded a signiicant between-group diference, with a sensitivity of 78.4% and speciicity of 89.9% to diferentiate a residual knee lexion contracture ≥ 10° (P = 0.001), patient satisfaction (P = 0.029), EuroQol 5-Dimension score (P = 0.028), anterior femoral curvature (P = 0.031), and Knee Injury and Osteoarthritis Outcome Score-Joint Replacement score (P = 0.046). Conclusion A pelvic incidence > 55° is associated with a residual knee lexion contracture ≥ 10° after TKA. The signiicance of the pelvic incidence measurement as a possible predictor of TKA outcome was highlighted, including its impact on patient satisfaction. Level of evidence III.

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Effect of Posterior Osteophytes on Total Knee Arthroplasty Coronal Soft Tissue Balance: Do They Matter?

Cited by 6 publications

References 16 publications

Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing

Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing

Anatomical and epidemiological examination of the structure and localization of osteophytes of cervical vertebrae in geriatric patients by using computed tomography method

The significance of the pelvic incidence measurement as a possible predictor of TKA outcome

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