Sagittal Gap Balancing with the Concept of a Single Radius Femoral Component in Posterior Cruciate Sacrificing Total Knee Arthroplasty with Patient-specific Instrumentation

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2014 Oct 3

PMID 25274129

Citations 5

Authors

Takehito Hananouchi

Affiliations

Soon will be listed here.

Abstract

Purpose: Sagittal gap balancing (relation between flexion and extension gaps) with placement of trial femoral components and reduction of the patella in total knee arthroplasty (TKA) is important, but it is not easy. The purpose of this study was to investigate whether (1) the flexion and extension gaps were equal when a previously suggested three-dimensional planning for a single-radius femoral component (its sagittal centre is matched with flexion-extension axis of knee movement) is executed with patient-specific instrumentation (PSI) and whether (2) PSI was done with good accuracy, which did not affect the first purpose.

Methods: Posterior cruciate ligament sacrificed (PS) TKA was performed on 12 joints. Using the patients' pre-operative computed tomography (CT) images, PSI was manufactured to fit on the bony surface of the knee joint and to simultaneously transfer pre-operative planning to the operating room. After osteotomy with PSI, gap measurements were calculated with the knee in flexion and extension. Angle deviations of both components were investigated with postoperative CT images.

Results: The flexion gap (mean, 19.1 mm) was larger than the extension gap (mean, 12.3 mm) in all cases. Angle differences between pre- and postoperative alignments were within 3° in all cases.

Conclusions: Although PSI executed the pre-operative planning with good accuracy, the flexion gap is always larger than the extension gap. This finding suggests that surgeons may not aim for equal gaps of flexion and extension in PS-TKA.

Citing Articles

Determining the Relationship between Mechanical Properties and Quantitative Magnetic Resonance Imaging of Joint Soft Tissues Using Patient-Specific Templates.

Hananouchi T, Satake S, Sakao K, Katsuda H, Shimada N, Dorthe E Bioengineering (Basel). 2023; 10(9).

PMID: 37760152 PMC: 10525776. DOI: 10.3390/bioengineering10091050.

Patient specific instrumentation versus conventional knee arthroplasty: comparative study.

Predescu V, Prescura C, Olaru R, Savin L, Botez P, Deleanu B Int Orthop. 2016; 41(7):1361-1367.

PMID: 27995304 DOI: 10.1007/s00264-016-3356-3.

3D-printing techniques in a medical setting: a systematic literature review.

Tack P, Victor J, Gemmel P, Annemans L Biomed Eng Online. 2016; 15(1):115.

PMID: 27769304 PMC: 5073919. DOI: 10.1186/s12938-016-0236-4.

Pre-operative radiological measurement of femoral rotation for prosthetic positioning in total knee arthroplasty.

Savin L, Botez P, Mihailescu D, Predescu V, Grierosu C Int Orthop. 2016; 40(9):1855-60.

PMID: 26803321 DOI: 10.1007/s00264-015-3110-2.

Intra-operative gaps affect outcome and postoperative kinematics in vivo following cruciate-retaining total knee arthroplasty.

Fujimoto E, Sasashige Y, Tomita T, Sasaki H, Touten Y, Fujiwara Y Int Orthop. 2015; 40(1):41-9.

PMID: 26133289 DOI: 10.1007/s00264-015-2847-y.

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