Restoration of the Joint Line in Total Knee Arthroplasty

Selvarajah, Elango; Hooper, Gary J.

doi:10.1016/j.arth.2008.06.030

Cited by 62 publications

(55 citation statements)

References 10 publications

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“…Probably the difference observed in our study depends on the sparing of the PCL in Selvarajah series. In fact, when the release of the PCL is performed in conjunction with a medial or lateral release as in our series, it is possible to observe an increase in the gaps [14][15][16], which could lead to an elevation of the joint line. Another possible explanation of the difference could be based on the difference in the landmarks used for the joint line evaluation.…”

Section: Discussionmentioning

confidence: 97%

“…3 Comparison of average differences of JL pre-and postoperative between the two techniques: on the left, gap balancing, and on the right measured resection our study is slightly different in comparison with those reported by other authors with non-navigated technique. Selvarajah et al [14], who employed a posterior cruciate ligament, retaining mobile-bearing total knee arthroplasty, found a joint line elevation of ?1.1 mm on average (SD = 4.1 mm) using the tip of the fibular as distal anatomical landmark. In their study, the range of variance between the pre-operative and post-operative joint line position was -11 mm to ?10 mm.…”

Section: Discussionmentioning

confidence: 98%

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Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

et al. 2011

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Navigation has been developed to help surgeons install implants more accurately and reproducibly; at the same time, this tool is able to record quantitative information such as joint range of motion, laxity and kinematics intra-operatively. As for standard surgery, two strategies are possible to achieve either femoral component rotation or overall prosthetic alignment: a measured gap resection approach, in which bone landmarks are used to guide resections equal to the distal and posterior thickness of the femoral component, or a gap-balancing technique, in which equal collateral ligament tension in flexion and extension is tried to find before as a guide to final bone cuts. The purpose of this paper is to compare the two different methods in a 67 patients group submitted to the same procedure using mobile-bearing (MB) prosthesis in order to analyse the effect of both techniques on joint line maintenance, axial limb restoration and components position. The gap group (GG) consists of 31 patients in whom the arthroplasty was performed using a navigated gap-balancing technique. The measured group (MG) consists of 36 patients in whom a computer-assisted measured resection technique was used. The results of imaging and the number of outliers were not statistically different (P = 0.56) for the mechanical axis and prosthetic positioning between the two groups. The gap technique showed a statistically significant alteration of the post-operative value when compared with the measured resection technique, (P = 0.036). The mean elevation of the joint line was 4.09 mm for the GG and 3.50 mm in the MG.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

et al. 2011

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“…Cope et al [5] in a radiologic study comparing joint line in cruciate-retaining versus cruciatesubstituting TKA reported a change of less than 0.5 mm in both the groups and no significant difference in the joint line change between the two groups. Selvarajah and Hooper [12] in a prospective study of 79 cruciate-retaining mobile bearing TKA reported an average joint line elevation of 1 mm. These results appear similar to those of this study in which the mean change in the joint line was 0 (range, −8.4 mm to 11.2 mm).…”

Section: Discussionmentioning

confidence: 98%

Computer guided restoration of joint line and femoral offset in cruciate substituting total knee arthroplasty

2012

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“…Entschei dend zur Vermeidung von Instabilitäten zwischen 0° und 90°, den sogenannten "Midflexions"Instabilitäten, ist die akku rate Rekonstruktion der Gelenklinie [25]. Obwohl einige Autoren keine negativen Folgen bei Verlagerung der Gelenklinie beschrieben [33,39], wurde von Anderen ein Zusammenhang zwischen Gelenk linienverschiebung und femoropatellaren Beschwerden [21], erhöhten retropatella ren Scherkräften [19], schlechterem funk tionellen Ergebnis [27,28] sowie Bewe gungseinschränkungen [5] nachgewiesen.…”

Section: Navigierte Implantation Weichteilbalancierter Knieendoprothesenunclassified

Navigierte Implantation weichteilbalancierter Knieendoprothesen

Schnurr

Stolzenberg

Neßler

et al. 2012

Oper Orthop Traumatol

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The analysis of 582 consecutive navigated total knee arthroplasties showed one case of extension gap instability > 3 mm (0.2%) and 8 patients with flexion gap instability > 3 mm (1.4%). A too tight flexion gap was registered in 23 patients (4.4%), a too wide flexion gap in 13 cases (2.5%). The joint line was reconstructed with an average inaccuracy of 0 mm, in 17 patients the joint line was elevated > 3 mm (2.9%).

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Restoration of the Joint Line in Total Knee Arthroplasty

Cited by 62 publications

References 10 publications

Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

Gap balancing versus measured resection technique using a mobile-bearing prosthesis in computer-assisted surgery

Computer guided restoration of joint line and femoral offset in cruciate substituting total knee arthroplasty

Navigierte Implantation weichteilbalancierter Knieendoprothesen

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