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Comparative Study
. 2014 Mar;38(3):531-7.
doi: 10.1007/s00264-013-2133-9. Epub 2013 Oct 22.

Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique

Tomoyuki Matsumoto  1 , Hirotsugu Muratsu, Yohei Kawakami, Koji Takayama, Kazunari Ishida, Takehiko Matsushita, Toshihiro Akisue, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka
Affiliations
Comparative Study

Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique

Tomoyuki Matsumoto et al. Int Orthop. 2014 Mar.

Abstract

Purpose: The purpose of this study was to prove the hypothesis that soft tissues are well balanced using the gap technique with a navigation system in cruciate-retaining (CR) and posterior-stabilised (PS) total knee arthroplasty (TKA), leading to better clinical outcomes compared with the measured-resection technique.

Methods: One hundred and thirty-five TKAs (90 CR and 45 PS) were performed in patients with varus-type osteoarthritis using the gap technique guided by the offset-type tensor and a navigation system. Soft-tissue balance (joint-component gap and ligament balance) were intraoperatively assessed with the tensor under 40 lb of joint-distraction force. The achievement in the equalised rectangular gap at extension and flexion was assessed and retrospectively compared with the previous series in which the measured-resection technique was used (20 CR and 100 PS TKAs). In addition, clinical outcomes, including range of motion and Knee Society Score were assessed at a minimum two year follow-up.

Results: In achieving equalised rectangular gaps at extension and flexion, CR TKAs met criteria in more cases [66.7% (64/90) vs. 44.4% (20/45) of PS TKA] with the gap technique, which was superior to that with the measured-resection technique [50.0% (10/20) of CR TKA and 28.0% (28/100) of PS TKA]. However, clinical outcomes showed no significant differences among groups at minimum two year follow-up.

Conclusions: The superiority of CR TKA with the gap technique in achieving equalised rectangular gaps at extension and flexion does not directly reflect two year postoperative clinical outcomes.

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Figures

Fig. 1
Fig. 1
Offset-type tensor. The tensor consists of three parts: upper seesaw plate, to which a shaped insert can be attached; a lower platform plate; an extra-articular main body. Two plates are connected to the extra-articular main body by the offset connection arm through a medial parapatellar arthrotomy, which permits reduction of the patellofemoral (PF) joint while performing measurements
See this image and copyright information in PMC

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References

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