Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty

Aims: It is unknown whether gap laxities measured in robotic arm-assisted total knee arthroplasty (TKA) correlate to load sensor measurements. The aim of this study was to determine whether symmetry of the maximum medial and lateral gaps in extension and flexion was predictive of knee balance in ext...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Richard J. Allom, Jil A. Wood, Darren B. Chen, Samuel J. MacDessi
Formato:	article
Lenguaje:	EN
Publicado:	The British Editorial Society of Bone & Joint Surgery 2021
Materias:	restricted kinematic alignment functional positioning virtual gap balancing load sensor total knee arthroplasty robot-assisted tka robotic arm laxities total knee arthroplasty (tka) flexion knees soft tissue balance valgus prospective cohort study medial proximal tibial angle lateral distal femoral angle Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/52de74790ae640e988612d2d756fcb46
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:52de74790ae640e988612d2d756fcb46
record_format	dspace
spelling	oai:doaj.org-article:52de74790ae640e988612d2d756fcb462021-12-01T18:44:47ZTibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty2633-146210.1302/2633-1462.211.BJO-2021-0066.R1https://doaj.org/article/52de74790ae640e988612d2d756fcb462021-11-01T00:00:00Zhttps://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.211.BJO-2021-0066.R1https://doaj.org/toc/2633-1462Aims: It is unknown whether gap laxities measured in robotic arm-assisted total knee arthroplasty (TKA) correlate to load sensor measurements. The aim of this study was to determine whether symmetry of the maximum medial and lateral gaps in extension and flexion was predictive of knee balance in extension and flexion respectively using different maximum thresholds of intercompartmental load difference (ICLD) to define balance. Methods: A prospective cohort study of 165 patients undergoing functionally-aligned TKA was performed (176 TKAs). With trial components in situ, medial and lateral extension and flexion gaps were measured using robotic navigation while applying valgus and varus forces. The ICLD between medial and lateral compartments was measured in extension and flexion with the load sensor. The null hypothesis was that stressed gap symmetry would not correlate directly with sensor-defined soft tissue balance. Results: In TKAs with a stressed medial-lateral gap difference of ≤1 mm, 147 (89%) had an ICLD of ≤15 lb in extension, and 112 (84%) had an ICLD of ≤ 15 lb in flexion; 157 (95%) had an ICLD ≤ 30 lb in extension, and 126 (94%) had an ICLD ≤ 30 lb in flexion; and 165 (100%) had an ICLD ≤ 60 lb in extension, and 133 (99%) had an ICLD ≤ 60 lb in flexion. With a 0 mm difference between the medial and lateral stressed gaps, 103 (91%) of TKA had an ICLD ≤ 15 lb in extension, decreasing to 155 (88%) when the difference between the medial and lateral stressed extension gaps increased to ± 3 mm. In flexion, 47 (77%) had an ICLD ≤ 15 lb with a medial-lateral gap difference of 0 mm, increasing to 147 (84%) at ± 3 mm. Conclusion: This study found a strong relationship between intercompartmental loads and gap symmetry in extension and flexion measured with prostheses in situ. The results suggest that ICLD and medial-lateral gap difference provide similar assessment of soft-tissue balance in robotic arm-assisted TKA. Cite this article: Bone Jt Open 2021;2(11):974–980.Richard J. AllomJil A. WoodDarren B. ChenSamuel J. MacDessiThe British Editorial Society of Bone & Joint Surgeryarticlerestricted kinematic alignmentfunctional positioningvirtual gap balancingload sensortotal knee arthroplastyrobot-assisted tkarobotic armlaxitiestotal knee arthroplasty (tka)flexionkneessoft tissue balancevalgusprospective cohort studymedial proximal tibial anglelateral distal femoral angleOrthopedic surgeryRD701-811ENBone & Joint Open, Vol 2, Iss 11, Pp 974-980 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	restricted kinematic alignment functional positioning virtual gap balancing load sensor total knee arthroplasty robot-assisted tka robotic arm laxities total knee arthroplasty (tka) flexion knees soft tissue balance valgus prospective cohort study medial proximal tibial angle lateral distal femoral angle Orthopedic surgery RD701-811
spellingShingle	restricted kinematic alignment functional positioning virtual gap balancing load sensor total knee arthroplasty robot-assisted tka robotic arm laxities total knee arthroplasty (tka) flexion knees soft tissue balance valgus prospective cohort study medial proximal tibial angle lateral distal femoral angle Orthopedic surgery RD701-811 Richard J. Allom Jil A. Wood Darren B. Chen Samuel J. MacDessi Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
description	Aims: It is unknown whether gap laxities measured in robotic arm-assisted total knee arthroplasty (TKA) correlate to load sensor measurements. The aim of this study was to determine whether symmetry of the maximum medial and lateral gaps in extension and flexion was predictive of knee balance in extension and flexion respectively using different maximum thresholds of intercompartmental load difference (ICLD) to define balance. Methods: A prospective cohort study of 165 patients undergoing functionally-aligned TKA was performed (176 TKAs). With trial components in situ, medial and lateral extension and flexion gaps were measured using robotic navigation while applying valgus and varus forces. The ICLD between medial and lateral compartments was measured in extension and flexion with the load sensor. The null hypothesis was that stressed gap symmetry would not correlate directly with sensor-defined soft tissue balance. Results: In TKAs with a stressed medial-lateral gap difference of ≤1 mm, 147 (89%) had an ICLD of ≤15 lb in extension, and 112 (84%) had an ICLD of ≤ 15 lb in flexion; 157 (95%) had an ICLD ≤ 30 lb in extension, and 126 (94%) had an ICLD ≤ 30 lb in flexion; and 165 (100%) had an ICLD ≤ 60 lb in extension, and 133 (99%) had an ICLD ≤ 60 lb in flexion. With a 0 mm difference between the medial and lateral stressed gaps, 103 (91%) of TKA had an ICLD ≤ 15 lb in extension, decreasing to 155 (88%) when the difference between the medial and lateral stressed extension gaps increased to ± 3 mm. In flexion, 47 (77%) had an ICLD ≤ 15 lb with a medial-lateral gap difference of 0 mm, increasing to 147 (84%) at ± 3 mm. Conclusion: This study found a strong relationship between intercompartmental loads and gap symmetry in extension and flexion measured with prostheses in situ. The results suggest that ICLD and medial-lateral gap difference provide similar assessment of soft-tissue balance in robotic arm-assisted TKA. Cite this article: Bone Jt Open 2021;2(11):974–980.
format	article
author	Richard J. Allom Jil A. Wood Darren B. Chen Samuel J. MacDessi
author_facet	Richard J. Allom Jil A. Wood Darren B. Chen Samuel J. MacDessi
author_sort	Richard J. Allom
title	Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
title_short	Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
title_full	Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
title_fullStr	Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
title_full_unstemmed	Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
title_sort	tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty
publisher	The British Editorial Society of Bone & Joint Surgery
publishDate	2021
url	https://doaj.org/article/52de74790ae640e988612d2d756fcb46
work_keys_str_mv	AT richardjallom tibiofemoraldynamicstressedgaplaxitiescorrelatewithcompartmentloadmeasurementsinroboticarmassistedtotalkneearthroplasty AT jilawood tibiofemoraldynamicstressedgaplaxitiescorrelatewithcompartmentloadmeasurementsinroboticarmassistedtotalkneearthroplasty AT darrenbchen tibiofemoraldynamicstressedgaplaxitiescorrelatewithcompartmentloadmeasurementsinroboticarmassistedtotalkneearthroplasty AT samueljmacdessi tibiofemoraldynamicstressedgaplaxitiescorrelatewithcompartmentloadmeasurementsinroboticarmassistedtotalkneearthroplasty
_version_	1718404691862224896

Tibiofemoral dynamic stressed gap laxities correlate with compartment load measurements in robotic arm-assisted total knee arthroplasty

Ejemplares similares