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. 2018 Jul 27;19(1):266.
doi: 10.1186/s12891-018-2190-8.

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Kyu-Jin Cho  1 , Jong-Keun Seon  1 , Won-Young Jang  1 , Chun-Gon Park  1 , Eun-Kyoo Song  2   3
Affiliations

Objective quantification of ligament balancing using VERASENSE in measured resection and modified gap balance total knee arthroplasty

Kyu-Jin Cho et al. BMC Musculoskelet Disord. .

Abstract

Background: Soft tissue balancing which is above all most important factor of total knee arthroplasty, has been performed by subjective methods. Recently objective orthosensor has been developed for compartment pressure measurement. The purpose of this study was: (1) to quantify the compartment pressure of the joint throughout the range of motion during TKA using orthosensor, (2) to determine the usefulness of orthosensor by analyzing correlation between the pressure in both compartment with initial trial and after final implantation, and (3) to evaluate the types and effectiveness of additional ligament balancing procedures to compartment pressure.

Methods: Eighty-four patients underwent total knee arthroplasty (TKA) using VERASENSE Knee System. TKA was performed by measured resection and modified gap balance technique. Compartment pressure was recorded on full extension, 30°, 60°, 90° and full flexion at initial (INI), after each additional procedure, and after final (FIN) implantation. "Balanced" knees were defined as when the compartment pressure difference was less than 15 pounds.

Results: Thirty patients (35.7%) showed balanced knee initially and 79 patients (94.0%) showed balance after final implantation. The proportion of balanced knee after initial bony resection, modified gap balancing TKAs showed significantly higher proportion than measured resection TKAs (P = 0.004) On both compartment, the pressure was generally decreased throughout the range of motion. Linear correlation on both compartment showed statistically significant throughout the range on motion, with higher correlation value on the lateral compartment. Total 66 additional ligament balancing procedures were performed.

Conclusion: Using orthosensor, we could obtain 94% quantified balance knee, consequently. And between the techniques, measured resection TKA showed less balanced knee and also required more additional procedures compared to modified gap balancing TKA. Furthermore, with the acquired quantified data during appropriate ligament balancing, the surgeon could eventually reduce the complications associated with soft tissue imbalance in the future.

Keywords: Gap-balance; Ligament balancing; Measured-resection; Orthosensor; Total knee arthroplasty.

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Conflict of interest statement

Ethics approval and consent to participate

The surgical procedure was approved by our institutional review board of Chonnam National University Hwasun Hospital, and written informed consent was obtained from all patients.

Competing interests

On behalf of all authors, the corresponding author states that there is no competing of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Quantification of medial and lateral compartment pressure using VERASENSE
Fig. 2
Fig. 2
VERASENSE inserted in the tibial tray in extension and flexion
Fig. 3
Fig. 3
Initial (INI) and final (FIN) absolute mediolateral pressure difference in measured resection (M) and modified gap balance techniques (G)
Fig. 4
Fig. 4
Proportion of knees according to initial (INI) and final (FIN) compartment pressure
Fig. 5
Fig. 5
Initial (INI) and final (FIN) average compartment pressure of overall (T), measured resection (M) and modified gap balance technique (G)
Fig. 6
Fig. 6
a-j Linear correlation between initial (INI) and final (FIN) compartment pressure
See this image and copyright information in PMC

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