The effect of flexion balance on functional outcomes in cruciate-retaining total knee arthroplasty

Oh, Chi-Ok; Song, Eun Kyoo; Seon, Jong Keun; Ahn, Yeong Seub

doi:10.1007/s00402-015-2159-0

Cited by 19 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Tibial component rotation was aligned to the line connecting the posterior cruciate ligament insertion site and the medial edge to medial 1/3 of the tibial tuberosity. Distal femoral preparation was carried out by intramedullary rod guide with 5° of valgus, and femoral rotation was determined according to the balanced flexion gap [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Cho

Seon

Jang

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundSoft tissue balancing which is above all most important factor of total knee arthroplasty, has been performed by subjective methods. Recently objective orthosensor has been developed for compartment pressure measurement. The purpose of this study was: (1) to quantify the compartment pressure of the joint throughout the range of motion during TKA using orthosensor, (2) to determine the usefulness of orthosensor by analyzing correlation between the pressure in both compartment with initial trial and after final implantation, and (3) to evaluate the types and effectiveness of additional ligament balancing procedures to compartment pressure.MethodsEighty-four patients underwent total knee arthroplasty (TKA) using VERASENSE Knee System. TKA was performed by measured resection and modified gap balance technique. Compartment pressure was recorded on full extension, 30°, 60°, 90° and full flexion at initial (INI), after each additional procedure, and after final (FIN) implantation. “Balanced” knees were defined as when the compartment pressure difference was less than 15 pounds.ResultsThirty patients (35.7%) showed balanced knee initially and 79 patients (94.0%) showed balance after final implantation. The proportion of balanced knee after initial bony resection, modified gap balancing TKAs showed significantly higher proportion than measured resection TKAs (P = 0.004) On both compartment, the pressure was generally decreased throughout the range of motion. Linear correlation on both compartment showed statistically significant throughout the range on motion, with higher correlation value on the lateral compartment. Total 66 additional ligament balancing procedures were performed.ConclusionUsing orthosensor, we could obtain 94% quantified balance knee, consequently. And between the techniques, measured resection TKA showed less balanced knee and also required more additional procedures compared to modified gap balancing TKA. Furthermore, with the acquired quantified data during appropriate ligament balancing, the surgeon could eventually reduce the complications associated with soft tissue imbalance in the future.

show abstract

Section: Methodsmentioning

confidence: 99%

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Cho

Seon

Jang

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…In the analysis of KOOS scores, there were 61 knees in group H and 56 knees in group L for the subscale of pain, 36 knees in group H and 81 knees in group L for the subscale of symptoms, and 45 knees in group H and 72 knees in group L for the subscale of ADL. In all three subscales, there were no significant differences in the patient characteristics and preoperative variables between the two groups (►Tables [1][2][3].…”

Section: Resultsmentioning

confidence: 92%

Both Intraoperative Medial and Lateral Joint Stabilities at Midflexion Influence Postoperative Patient-Reported Outcome Measures Following Bi-Cruciate Stabilized Total Knee Arthroplasty

et al. 2022

View full text Add to dashboard Cite

Bi-cruciate stabilized (BCS) total knee arthroplasty (TKA) was developed to approximate normal knee kinematics and is expected to improve clinical outcomes. However, the effects of soft tissue balance at the medial or lateral compartment on patient-reported outcome measures (PROMs) following BCS TKA are unclear. The purpose of this study was to clarify the relationship between the medial or lateral component gaps and PROMs following BCS TKA. One hundred seventeen knees with varus deformities which underwent BCS TKA were included in this study. They were divided into two groups according to the validated Japanese version of the Knee Injury and Osteoarthritis Outcome Score for each subscale of pain, symptoms, and activities of daily living (ADL) at 1 year postoperatively: group H consisted of patients with ≥90 points and group L consisted of patients with <90 points. Intraoperative medial and lateral joint laxities at 0°, 30°, 60°, 90°, and 120° flexion measured using a tensor device were compared between the two groups in each subscale. In the pain subscale, the medial joint laxities at 30° (p < 0.05) and 60° flexion (p < 0.05) in group H were significantly smaller than those in group L. In the ADL subscale, the medial joint laxity at 60° flexion in group H was significantly smaller than that in group L (p < 0.05). In the symptom subscale, the lateral joint laxity at 60° flexion in group H was significantly smaller than that in group L (p < 0.05). Surgeons should pay attention to the importance of both medial and lateral joint stabilities to achieve better postoperative PROMs following BCS TKA.

show abstract

“…The 2 studies reporting on coronal stress radiography in flexion (Oh et al. 2015, Tsukiyama et al. 2017), found comparable mean opening angles (Table 3).…”

Section: Discussionmentioning

confidence: 89%

“…(2017) and Oh et al. (2015) reported on stress radiography in flexion using the epicondylar view with coronal stress applied and measured by a spring scale. Following stratification, significant association was obtained in both studies.…”

Section: Resultsmentioning

confidence: 99%

Relationship between outcome scores and knee laxity following total knee arthroplasty: a systematic review

et al. 2018

View full text Add to dashboard Cite

Background and purpose — Instability following primary total knee arthroplasty (TKA) is, according to all national registries, one of the major failure mechanisms leading to revision surgery. However, the range of soft-tissue laxity that favors both pain relief and optimal knee function following TKA remains unclear. We reviewed current evidence on the relationship between instrumented knee laxity measured postoperatively and outcome scores following primary TKA.Patients and methods — We conducted a systematic search of PubMed, Embase, and Cochrane databases to identify relevant studies, which were cross-referenced using Web of Science.Results — 14 eligible studies were identified; all were methodologically similar. Both sagittal and coronal laxity measurement were reported; 6 studies reported on measurement in both extension and flexion. In knee extension from 0° to 30° none of 11 studies could establish statistically significant association between laxity and outcome scores. In flexion from 60° to 90° 6 of 9 studies found statistically significant association. Favorable results were reported for posterior cruciate retaining (CR) knees with sagittal laxity between 5 and 10 mm at 75–80° and for knees with medial coronal laxity below 4° in 80–90° of flexion.Interpretation — In order to improve outcome following TKA careful measuring and adjusting of ligament laxity intraoperatively seems important. Future studies using newer outcome scores supplemented by performance-based scores may complement current evidence.

show abstract

The effect of flexion balance on functional outcomes in cruciate-retaining total knee arthroplasty

Abstract: These results suggest that total knees with good balanced flexion stability can provide good functional outcomes after TKA.

Cited by 19 publications

References 19 publications

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Both Intraoperative Medial and Lateral Joint Stabilities at Midflexion Influence Postoperative Patient-Reported Outcome Measures Following Bi-Cruciate Stabilized Total Knee Arthroplasty

Relationship between outcome scores and knee laxity following total knee arthroplasty: a systematic review

Contact Info

Product

Resources

About