Intraoperative Soft Tissue Balance Using Novel Medial Preserving Gap Technique in Posterior-stabilized Total Knee Arthroplasty: Comparison to Measured Resection Technique

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2018 Apr 23

PMID 29680905

Citations 10

Authors

Kanto Nagai

Hirotsugu Muratsu

Yutaro Kanda

Masanori Tsubosaka

Tomoyuki Kamenaga

Hidetoshi Miya

Takehiko Matsushita

Takahiro Niikura

Ryosuke Kuroda

Tomoyuki Matsumoto

Affiliations

Soon will be listed here.

Abstract

Purpose: To investigate intraoperative soft tissue balance with femoral component trial in place using a novel medial preserving gap technique, focusing on medial compartment stability and allowing lateral physiological laxity, with compared with using a measured resection technique in posterior-stabilized (PS) total knee arthroplasty (TKA).

Methods: Primary PS TKA, using either medial preserving gap technique (n = 127) or measured resection technique (n = 148), was performed in 275 subjects with varus knee osteoarthritis. Intraoperative soft tissue balance with femoral component in place was assessed using Offset Repo-Tensor with 40 lbs. of joint distraction force throughout the range of motion, and medial and lateral compartment gaps (mm) were calculated. Medial and lateral joint gap changes (mm) were calculated by subtracting the medial/lateral compartment gap at 0° from the medial/lateral compartment gap at each knee flexion angle, respectively.

Results: Medial and lateral joint gap changes in medial preserving gap technique were significantly smaller than measured resection technique respectively (mean difference between two procedures: medial; 0.9 ± 0.2 mm, lateral; 1.0 ± 0.3 mm). Medial and lateral joint gaps were significantly changed during knee flexion in measured resection technique, whereas medial and lateral joint gaps were not significantly changed during mid-to-deep knee flexion (30°-90° in medial, 30°-120° in lateral) in medial preserving gap technique.

Conclusions: Medial preserving gap technique provided more consistent intraoperative soft tissue balance during knee flexion than the measured resection technique, suggesting that this novel technique can be utilized to obtain a more stable joint gap in PS TKA.

Level Of Evidence: III.

Citing Articles

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The Effect of Severe Varus Deformity on Clinical and Radiographic Outcomes in Mechanical Aligned Total Knee Arthroplasty with Medial Stabilizing Technique.

Lee S, Jung J, Kim H, Kim J, Jung I, Kim J J Clin Med. 2024; 13(6).

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Medial Soft Tissue-Preserving Technique Impact on Sagittal Stability in Bi-cruciate Stabilized Total Knee Arthroplasty.

Seki K, Seki T, Imagama T, Matsuki Y, Kaneoka T, Kawakami T Indian J Orthop. 2023; 57(7):1049-1053.

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Limited medial posterior capsular release increases the intraoperative medial component gap while maintaining the joint varus angle at extension in posterior-stabilized total knee arthroplasty.

Katagiri H, Saito R, Shioda M, Jinno T, Watanabe T Knee Surg Sports Traumatol Arthrosc. 2023; 31(10):4187-4194.

PMID: 37195474 DOI: 10.1007/s00167-023-07425-9.

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