Posterior cruciate ligament balancing in total knee replacement

Christen, Bernhard; Heesterbeek, Petra J.C.; Wymenga, A. B.; Wehrli, U.

doi:10.1302/0301-620x.89b8.18976

Cited by 49 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This result differed from that of the previous study [2], in which a 1-mm flexion gap increase led to a 1.25-mm increase in anterior tibial translation. The reason for this discrepancy probably lies in different operation techniques associated with the different surgical approaches and different TKR implants.…”

Section: Discussioncontrasting

confidence: 99%

“…The authors implanted balanSys knees with a slope of 7° and carried out the measurements in 97° flexion, which makes the study comparable to that of Christen et al [2] in which a mean relation of 1:1.25 between gap height and anterior tibial translation after flexion gap distraction with a monoblock tensioner was documented. Heesterbeek et al [10] compared the studies and explained their higher amount of tibial translation as a result of the different tensioners that were used.…”

Section: Discussionmentioning

confidence: 63%

“…Thus, our hypothesis suggesting pronounced tibial translation in knees with intact PCL was not confirmed. The two different situations for each knee, with and without posterior cruciate ligament, were assessed using methods from the earlier study by Christen et al [2]. In contrast to the previous study, the patients were treated using a less invasive midvastus surgical approach and different knee prosthesis.…”

Section: Discussionmentioning

confidence: 99%

“…After complete resection of the remaining tibial bone block and PCL, the measurements were repeated in the same way.

Fig. 1The figure shows intraoperative views of the tensioner [2] during a placement in the knee joint, b selection of the tension force, c measurement of flexion gap and d measurement of tibial translation…”

Section: Methodsmentioning

confidence: 99%

“…The figure shows intraoperative views of the tensioner [2] during a placement in the knee joint, b selection of the tension force, c measurement of flexion gap and d measurement of tibial translation…”

Section: Methodsmentioning

confidence: 99%

See 4 more Smart Citations

No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement

Christen

Neukamp

Aghayev

2011

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThe relative advantages of cruciate retaining or cruciate resecting total knee replacement are still controversial. If the posterior cruciate ligament (PCL) is preserved, it should be properly balanced. In a previous study, it was demonstrated that increasing the flexion gap leads to an anterior translation of the tibia relative to the femur. Based on these results, we hypothesized that cutting the PCL increases the flexion gap and lessens anterior tibial translation.MethodsThe amount of anterior tibial translation versus distraction force in the flexion gap was measured in 88 total knee replacements with a less invasive midvastus approach using a custom-made tensioner. Measurements were performed with intact and resected PCL.ResultsThe difference in tibial translation with and without PCL is not significant. A 1-mm increase in the flexion gap led to an average anterior translation of 0.6 mm with intact PCL and 0.4 mm with cut PCL, which is less than that reported in a previous study.ConclusionsThe results have not confirmed our initial hypothesis. The reasons for this may be other soft tissue structures that prevent anterior tibial translation, such as the collateral ligaments, and/or the extensor apparatus. Moreover, the knee flexion angle for the used specific implant may play a role.Level of evidenceProspective comparative study, Level II.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

“…After complete resection of the remaining tibial bone block and PCL, the measurements were repeated in the same way.

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement

Christen

Neukamp

Aghayev

2011

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis

Verra

Boom

Jacobs

et al. 2013

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

The methodological quality and the quality of reporting of the studies were highly variable. With respect to range of motion, pain, clinical, and radiological outcomes, no clinically relevant differences were found between total knee arthroplasty with retention or sacrifice of the posterior cruciate ligament. Two statistically significant differences were found; range of motion was 2.4 ° higher in the posterior cruciate ligament sacrificing group, however results were heterogeneous; and the mean functional Knee Society Score was 2.3 points higher in the posterior cruciate ligament sacrificing group. These differences are clinically not relevant.

show abstract

In vivo kinematics of knee replacement during daily living activities: Condylar and post-cam contact assessment by three-dimensional fluoroscopy and finite element analyses

et al. 2016

View full text Add to dashboard Cite

In total knee replacement, the investigation on the exact contact patterns at the post-cam in implanted patients from real in vivo data during daily living activities is fundamental for validating implant design concepts and assessing relevant performances. This study is aimed at verifying the restoration of natural tibio-femoral condylar kinematics by investigating the post-cam engagement at different motor tasks. An innovative validated technique, combining three-dimensional fluoroscopic and finite element analyses, was applied to measure joint kinematics during daily living activities in 15 patients implanted with guided motion posterior-stabilized total knee replacement. Motion results showed physiological antero-posterior translations of the tibio-femoral condyles for every motor task. However, high variability was observed in the position of the calculated pivot point among different patients and different motor tasks, as well as in the range of post-cam engagement. Physiological tibio-femoral joint rotations and contacts at the condyles were found restored in the present knee replacement. Articular contact patterns experienced at the post-cam were found compatible with this original prosthesis design. The present study reports replaced knee kinematics also in terms of articular surface contacts, both at the condyles and, for the first time, at the post-cam. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1396-1403, 2017.

show abstract

Posterior cruciate ligament balancing in total knee replacement

Cited by 49 publications

References 35 publications

No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement

No difference in anterior tibial translation with and without posterior cruciate ligament in less invasive total knee replacement

Retention versus sacrifice of the posterior cruciate ligament in total knee arthroplasty for treating osteoarthritis

In vivo kinematics of knee replacement during daily living activities: Condylar and post-cam contact assessment by three-dimensional fluoroscopy and finite element analyses

Contact Info

Product

Resources

About