Contact Kinematic Differences Between Gap Balanced vs Measured Resection Techniques for Single Radius Posterior-Stabilized Total Knee Arthroplasty

Measured resection (MR) and gap balancing (GB) are common surgical techniques for total knee arthroplasty (TKA). Controversy has arisen as each conceptually differs in how the knee is balanced through bone and soft tissue management. The objective of the present study was to compare both the frequen...

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Veröffentlicht in:The Journal of arthroplasty Jg. 32; H. 6; S. 1834 - 1838
Hauptverfasser: Teeter, Matthew G., Perry, Kevin I., Yuan, Xunhua, Howard, James L., Lanting, Brent A.
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.06.2017
Schlagworte:
Aged
Arthroplasty, Replacement, Knee - methods
Biomechanical Phenomena
Cohort Studies
Female
gap balancing
Humans
kinematics
Knee - surgery
Knee Joint - surgery
Knee Prosthesis
Male
measured resection
Middle Aged
Orthopedics
Osteoarthritis, Knee - surgery
Postoperative Period
radiostereometric analysis
Range of Motion, Articular
single radius femoral component
total knee arthroplasty
single radius femoral component
total knee arthroplasty
kinematics
radiostereometric analysis
gap balancing
measured resection
ISSN:0883-5403, 1532-8406
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Zusammenfassung:Measured resection (MR) and gap balancing (GB) are common surgical techniques for total knee arthroplasty (TKA). Controversy has arisen as each conceptually differs in how the knee is balanced through bone and soft tissue management. The objective of the present study was to compare both the frequency of condylar liftoff and the location of femorotibial contact from extension through midflexion between patients undergoing GB or MR TKA. A total of 24 knees (23 patients) were randomly assigned at referral to either a surgeon performing MR or GB TKA with the same single radius, posterior-stabilized implant (12 per cohort). At 1-year postoperation, patients underwent biplanar radiographic imaging at 0°, 20°, 40°, and 60° of flexion. Condylar liftoff, contact location, and magnitude of excursion on each condyle were measured. Preoperative and postoperative clinical outcome scores were also collected. There was no difference (P = .41) in the frequency of liftoff between cohorts. The MR cohort had more posterior contact on the medial condyle (P < .01) and more anterior contact on the lateral condyle (P < .01) throughout flexion. Motion patterns were similar between cohorts, with similar medial (P = .48) and lateral (P = .44) excursion, which was equal in magnitude between condyles for both MR (P = .48) and GB (P = .73). There was no difference in clinical outcome scores between groups. For this particular implant system, GB and MR appear to produce similar kinematic and patient-reported outcome results.
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ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2016.12.054