Medial stabilizing technique preserves anatomical joint line and increases range of motion compared with the gap-balancing technique in navigated total knee arthroplasty

Ishíbashi, K.; Sasaki, Eiji; Sasaki, Shizuka; Kimura, Yuka; Yamamoto, Yuji; Ishibashi, Yasuyuki

doi:10.1016/j.knee.2019.12.002

Cited by 14 publications

(21 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, TKA with MST was introduced to minimise medial soft tissue release and to allow residual lateral laxity. MST has demonstrated excellent postoperative outcomes without joint line elevation or subjective instability [11, 36]. The mean joint line distance increased by 1.6 mm; both groups showed excellent postoperative clinical outcomes with similar joint line distance changes in the present study.…”

Section: Discussionsupporting

confidence: 80%

“…Extensive medial release might be associated with mid‐flexion instability and joint line elevation, which cause postoperative knee pain and poor functional outcomes [41]. A cadaveric study demonstrated that a joint line change of > 2 mm was associated with a decreased flexion angle [11]. Furthermore, joint line elevation reportedly causes patella baja, resulting in poor clinical outcomes [40, 41].…”

Section: Discussionmentioning

confidence: 99%

“…Medial instability after TKA may be the causative factor for postoperative knee pain and poor functional outcomes [18, 39]. The medial stabilising technique (MST) was introduced to overcome potential problems following excessive medial release [11]. Its main concept is to minimise medial soft tissue release and allow lateral laxity (Fig.…”

Section: Introductionmentioning

confidence: 99%

“…1). MST in TKA reportedly has similar outcomes to that in conventional TKA without joint line elevation [11, 36]. Medial tightness and lateral laxity do not remain after MST TKA because osteophytes are removed and the deep MCL is released [22, 36].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique

Lee

Alharthi

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThis study was aimed to compare the clinical, functional, and radiographic outcomes between symmetric and asymmetric extension and mediolateral gap balance after navigation‐assisted (NA) total knee arthroplasty (TKA) using ultracongruent (UC) insets and the medial stabilising technique (MST). MethodsIn all, 363 knees of 275 patients who underwent mechanical alignment‐target NA TKA with MST between January 2015 and December 2017 were analysed. Patients were divided into balanced (extension mediolateral gap difference ≤ 2 mm) and tight medial (difference ≥ 3 mm) groups. Pre‐ and postoperative clinical, functional (range of motion, Western Ontario and McMaster University Osteoarthritis [WOMAC] index, Knee Society Knee Score [KSKS], and Knee Society Function Score [KSFS]) and radiographic (hip–knee–ankle [HKA] angle, femoral condylar offset, extension angle [a minus indicates hyperextension], and joint line distance) outcomes were compared between the groups. Student’s t‐ or Chi‐squared test was used to compare the outcomes. ResultsAmong the 363 knees analysed, 279 (77%) were assigned to the balanced group and 84 (23%) to the tight medial group. The preoperative HKA angle was significantly greater in the tight medial group than in the balanced group (9.7° ± 4.1° vs 14.3° ± 4.7°, P < 0.001). The postoperative WOMAC index, KSKS, and KSFS were similar between the groups. The change in the joint line distance was not significantly different (1.5 ± 3.7 vs 2.0 ± 3.3; n.s). ConclusionThe clinical, functional, and radiographic outcomes, including joint line distance, were comparable between the tight medial and balanced group after mechanical alignment‐targeted UC TKA with MST. Level of evidenceLevel III, retrospective comparative study.

show abstract

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique

Lee

Alharthi

et al. 2023

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Briefly, we removed the exact thickness of bone and cartilage from the distal side of the femoral lateral condyle, posterior site of the femoral medial condyle, and proximal side of the tibial lateral condyle, as this was needed to implant the components. The medial stabilizing technique 19 was used, and we intraoperatively confirmed that the difference between the medial gap at 90°flexion and that at extension was 3 mm or less using spacer blocks; posterior-stabilized implants (Triathlon; Stryker Kalamazoo, MI) were used for all TKAs. The CT-free navigation system was also used during cementing to confirm the rotational position of the tibial component.…”

Section: Surgical Procedures For Tkamentioning

confidence: 73%

Relationship between the Femoral and Tibial Component Positions and Postoperative Knee Range of Motion after Posterior-Stabilized Total Knee Arthroplasty in Varus-Aligned Knees

Hanada

Hotta

Koyama³

et al. 2022

J Knee Surg

View full text Add to dashboard Cite

This study aimed to evaluate the relationship between the femoral and tibial component positions and postoperative knee range of motion after posterior-stabilized total knee arthroplasty (TKA). Forty-four patients (48 knees in total: 9 men, 9 knees; 35 women, 39 knees) who underwent posterior-stabilized TKA using a navigation system were included. The femoral and tibial component positions were measured from the preoperative and postoperative computed tomography data with three-dimensional evaluation software. We investigated the relationship between the knee range of motion, including extension restriction and maximum flexion angles at 2 years postoperatively, and the femoral and tibial component positions. Patients with knee extension restriction of 10° or more at 2 years postoperatively showed greater posterior flexion position of the tibial component than those with knee extension restriction less than 10° (6.2° and 3.9°, respectively, p=0.018). The postoperative knee flexion angle was positively associated with the internal rotational position of the femoral component (p=0.032, 95% confidence interval: 0.105–2.178). Patients with a knee flexion angle more than 120° at 2 years postoperatively had greater internal rotational position of the femoral component than those with 120° or less (5.2° and 1.5°, respectively, p=0.002). In conclusions, after posterior-stabilized TKA, the postoperative knee extension restriction angle was associated with the posterior flexion position of the tibial component, and the knee flexion angle was positively related to the internal rotational position of the femoral component.

show abstract

Mobile bearing shows larger rollback motion than fixed bearing in total knee arthroplasty using a medial stabilising technique with a navigation system

Tsushima,

Sasaki,

Sasaki

et al. 2024

J. exp. orthop.

View full text Add to dashboard Cite

PurposeThis study aimed to investigate the intraoperative knee kinematics of cruciate‐retaining total knee arthroplasty with a medial stabilising technique (MST‐TKA) and compare the kinematics between mobile‐ and fixed‐bearing MST‐TKAs. We hypothesised that mobile‐bearing MST‐TKA would result in greater physiological kinematic motion than fixed‐bearing MST‐TKA.MethodsTwenty‐one and 20 knees underwent mobile‐ and fixed‐bearing MST‐TKAs using a navigation system (Orthopilot® ver. 6.0; B. Braun Aesculap), respectively. In the preoperative and postoperative kinematic analysis, the knee was moved manually from 0° to 120°, and femoral anteroposterior translations of the medial femoral condyle (MFC) and lateral femoral condyle (LFC) were recorded every 0.1 s from 0° to 120°. Data were subsequently extracted from the software every 10° of flexion and compared between the two groups, and the correlation coefficients between preoperative and postoperative kinematics were calculated.ResultsIn the postoperative analysis, the MFC in the mobile‐bearing group showed significant posterior translation at 100°, 110° and 120° compared to the fixed‐bearing group (p < 0.01). Similarly, the LFC in the mobile‐bearing group showed significant posterior translation at 100°, 110° and 120° compared to the fixed‐bearing group (p < 0.05, p < 0.01 and p < 0.05, respectively). In the mobile‐bearing group, the preoperative and postoperative anteroposterior translations of the MFC and LFC were correlated (p < 0.01), while in the fixed‐bearing group, there was no correlation.ConclusionThe femoral rollback motion in the mobile‐bearing MST‐TKA correlated with the preoperative kinematics and was larger than that in the fixed‐bearing group.Level of EvidenceLevel II, therapeutic prospective cohort study.

show abstract

Medial stabilizing technique preserves anatomical joint line and increases range of motion compared with the gap-balancing technique in navigated total knee arthroplasty

Cited by 14 publications

References 28 publications

Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique

Effect of mediolateral gap difference on postoperative outcomes in navigation-assisted total knee arthroplasty using an ultracongruent insert and the medial stabilising technique

Relationship between the Femoral and Tibial Component Positions and Postoperative Knee Range of Motion after Posterior-Stabilized Total Knee Arthroplasty in Varus-Aligned Knees

Mobile bearing shows larger rollback motion than fixed bearing in total knee arthroplasty using a medial stabilising technique with a navigation system

Contact Info

Product

Resources

About