The Computer-assisted Sequential Lateral Soft-tissue Release in Total Knee Arthroplasty for Valgus Knees

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2007 Jan 12

PMID 17216522

Citations 11

Authors

C Luring

F Oczipka

J Grifka

L Perlick

Affiliations

Soon will be listed here.

Abstract

Soft-tissue management is a critical factor in total knee arthroplasty, especially in valgus knees. The stepwise release has been based upon surgeon's experience. Computer-assisted surgery has gained increasing scientific interest in recent times and allows the intraoperative measurement of leg axis and gap size in extension and flexion. We therefore aimed to analyse the effect of sequential lateral soft-tissue release and the resulting change in the a.p. limb axis on the one hand and the tibiofemoral gaps on the other hand in extension as well as in flexion in eight cadaveric knees. Measurements were obtained using a CT-free navigation system. In extension the highest increase compared to the previous release step was found for the first (iliotibial band, P = 0.002), second (popliteus muscle, P = 0.0003), third (LCL, 0.007) and the sixth (entire PCL, P = 0.001) release step. In 90 degrees flexion all differences of the lateral release steps were statistically significant (P < 0.004). Massive progression of the lateral gap in flexion was found after the second (popliteus muscle, P = 0.004) and third (LCL, 0.007) release step. Computer-assisted surgery allows measurement of the effect of each release step of the sequential lateral release sequence and helps the surgeon to better assess the result.

Citing Articles

Total knee arthroplasty with the least-constrained implant possible for type II valgus knee > 20°: a 3-14 years' follow-up.

Ren J, Zhang X, Wulamu W, Yushan N, Aaimaiti A, Cao L Arthroplasty. 2022; 2(1):17.

PMID: 35236440 PMC: 8796588. DOI: 10.1186/s42836-020-00036-6.

Incidence of Soft-Tissue Releases, Clinical and Radiological Outcomes of Lateral Parapatellar Approach for Valgus Arthritic Knees: A 4-year Follow-up Study with A Review of Literature.

Dalal S, Chandratreya A, Singhal K, Kotwal R Indian J Orthop. 2021; 55(Suppl 1):38-45.

PMID: 34122753 PMC: 8149535. DOI: 10.1007/s43465-020-00294-1.

The effects of soft tissue lateral release on the stability of the ligament complex of the knee.

Vollner F, Herl F, Greimel F, Benditz A, Renkawitz T, Grifka J Arch Orthop Trauma Surg. 2020; 140(7):933-940.

PMID: 32232619 PMC: 7295728. DOI: 10.1007/s00402-020-03422-6.

NAVIGATION IN TOTAL KNEE ARTHROPLASTY.

da Mota E Albuquerque R Rev Bras Ortop. 2016; 46(1):18-22.

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Total knee arthroplasty for valgus osteoarthritis: the results of a standardized soft-tissue release technique.

Boettner F, Renner L, Arana Narbarte D, Egidy C, Faschingbauer M Knee Surg Sports Traumatol Arthrosc. 2016; 24(8):2525-31.

PMID: 26939552 DOI: 10.1007/s00167-016-4054-9.

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