What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study

Background: Posterior compartment knee osteophytes may pose a challenge in achieving soft-tissue balance during total knee arthroplasty (TKA). Obtaining symmetry of flexion and extension gaps involves balance of both bony and soft-tissue structures. We hypothesize that space-occupying posteromedial...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	David C. Holst, MD, Gary W. Doan, MS, Marc R. Angerame, MD, Martin W. Roche, MD, Chadd W. Clary, PhD, Douglas A. Dennis, MD
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Posterior osteophytes total knee arthroplasty Ligament balance Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/ce0fb3bbb2344ca0804a775413285eb0
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ce0fb3bbb2344ca0804a775413285eb0
record_format	dspace
spelling	oai:doaj.org-article:ce0fb3bbb2344ca0804a775413285eb02021-11-14T04:33:58ZWhat is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study2352-344110.1016/j.artd.2021.08.007https://doaj.org/article/ce0fb3bbb2344ca0804a775413285eb02021-10-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352344121001412https://doaj.org/toc/2352-3441Background: Posterior compartment knee osteophytes may pose a challenge in achieving soft-tissue balance during total knee arthroplasty (TKA). Obtaining symmetry of flexion and extension gaps involves balance of both bony and soft-tissue structures. We hypothesize that space-occupying posteromedial femoral osteophytes affect soft-tissue balance. Methods: Five cadaveric limbs were acquired. Computed tomography scans were obtained to define the osseous contours. Three-dimensionally printed, specimen-specific synthetic posterior femoral osteophytes were fabricated in 10-mm and 15-mm sizes. TKAs were implanted. Medial and lateral compartment contact forces were measured during passive knee motion using pressure-sensing technology. For each specimen, trials were completed without osteophytes and with 10-mm and 15-mm osteophytes affixed to the posteromedial femoral condyle. Contact forces were obtained at full extension, 10°, 30°, 45°, 60°, and 90° of flexion. These were recorded across each specimen in each condition for three trials. Tukey post hoc tests were used with a repeated measures ANOVA for statistical data analysis. Results: The presence of posteromedial osteophytes increased asymmetric loading from full extension to 45° of flexion, with statistically significant differences observed at full extension and 30°. A reduction in lateral compartment forces was noted. The 25%-75% bounds of variability in the contact force was less than 3.5 lbs. Conclusions: Posteromedial femoral osteophytes caused an asymmetric increase in medial contact forces from full extension continuing into mid-flexion. The soft-tissue imbalance created from these osteophytes supports their removal before performing ligament releases to obtain desired soft-tissue balancing during TKA.David C. Holst, MDGary W. Doan, MSMarc R. Angerame, MDMartin W. Roche, MDChadd W. Clary, PhDDouglas A. Dennis, MDElsevierarticlePosterior osteophytestotal knee arthroplastyLigament balanceOrthopedic surgeryRD701-811ENArthroplasty Today, Vol 11, Iss , Pp 127-133 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Posterior osteophytes total knee arthroplasty Ligament balance Orthopedic surgery RD701-811
spellingShingle	Posterior osteophytes total knee arthroplasty Ligament balance Orthopedic surgery RD701-811 David C. Holst, MD Gary W. Doan, MS Marc R. Angerame, MD Martin W. Roche, MD Chadd W. Clary, PhD Douglas A. Dennis, MD What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
description	Background: Posterior compartment knee osteophytes may pose a challenge in achieving soft-tissue balance during total knee arthroplasty (TKA). Obtaining symmetry of flexion and extension gaps involves balance of both bony and soft-tissue structures. We hypothesize that space-occupying posteromedial femoral osteophytes affect soft-tissue balance. Methods: Five cadaveric limbs were acquired. Computed tomography scans were obtained to define the osseous contours. Three-dimensionally printed, specimen-specific synthetic posterior femoral osteophytes were fabricated in 10-mm and 15-mm sizes. TKAs were implanted. Medial and lateral compartment contact forces were measured during passive knee motion using pressure-sensing technology. For each specimen, trials were completed without osteophytes and with 10-mm and 15-mm osteophytes affixed to the posteromedial femoral condyle. Contact forces were obtained at full extension, 10°, 30°, 45°, 60°, and 90° of flexion. These were recorded across each specimen in each condition for three trials. Tukey post hoc tests were used with a repeated measures ANOVA for statistical data analysis. Results: The presence of posteromedial osteophytes increased asymmetric loading from full extension to 45° of flexion, with statistically significant differences observed at full extension and 30°. A reduction in lateral compartment forces was noted. The 25%-75% bounds of variability in the contact force was less than 3.5 lbs. Conclusions: Posteromedial femoral osteophytes caused an asymmetric increase in medial contact forces from full extension continuing into mid-flexion. The soft-tissue imbalance created from these osteophytes supports their removal before performing ligament releases to obtain desired soft-tissue balancing during TKA.
format	article
author	David C. Holst, MD Gary W. Doan, MS Marc R. Angerame, MD Martin W. Roche, MD Chadd W. Clary, PhD Douglas A. Dennis, MD
author_facet	David C. Holst, MD Gary W. Doan, MS Marc R. Angerame, MD Martin W. Roche, MD Chadd W. Clary, PhD Douglas A. Dennis, MD
author_sort	David C. Holst, MD
title	What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
title_short	What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
title_full	What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
title_fullStr	What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
title_full_unstemmed	What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study
title_sort	what is the effect of posterior osteophytes on flexion and extension gaps in total knee arthroplasty? a cadaveric study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/ce0fb3bbb2344ca0804a775413285eb0
work_keys_str_mv	AT davidcholstmd whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy AT garywdoanms whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy AT marcrangeramemd whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy AT martinwrochemd whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy AT chaddwclaryphd whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy AT douglasadennismd whatistheeffectofposteriorosteophytesonflexionandextensiongapsintotalkneearthroplastyacadavericstudy
_version_	1718429986134687744

What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study

Ejemplares similares