scholarly journals Femoral Component Alignment Boundaries for Tibia First Gap Balancing using Digital Tensioning Tool

10.29007/9p46 ◽  
2020 ◽  
Author(s):  
Edgar Wakelin ◽  
Sami Shalhoub ◽  
Jeffrey Lawrence ◽  
John Keggi ◽  
Jeffrey DeClaire ◽  
...  
Keyword(s):  
Los Angeles ◽  
Femoral Component ◽  
Patient Outcomes ◽  
Component Alignment ◽  
Small Deviations ◽  
Gap Balancing ◽  
Axial Alignment ◽  
Outcome Scores ◽  
Total Knee ◽  
Tibiofemoral Alignment

Achieving a balanced knee is a critical aspect of Total Knee Arthroplasty (TKA). Coronal and axial boundaries for femoral component placement to achieve balance however, are not well defined. Our aim is to investigate the effect of femoral component and long leg coronal and axial alignment on patient outcomes when using a tibia-first gap balancing technique.All surgeries were performed using the OMNIBotics robot-assisted TKA platform and BalanceBot device. A total of 197 patients were prospectively enrolled into this study and received TKA surgery using the OMNIBotics platform and completed 1-year KOOS outcome scores. Femoral component and tibiofemoral alignment were categorized as inliers or outliers in the coronal and axial planes. Knee Injury and Osteoarthritis Outcome Score (KOOS), and University of California at Los Angeles Activity Scale (UCLA) was collected at 1-year post-op.No significant differences were found between the KOOS subscores or UCLA outcome and femoral coronal or tibiofemoral coronal and axial alignment. Significant differences were found between the KOOS pain and sports sub-scores and femoral axial alignment (∆ = 5.4, p = 0.007, ∆ = 8.3, p = 0.03 respectively), in which outlier femoral rotation reported higher scores.Component alignment limits for improved survival and patient outcomes are a source of ongoing debate. The data presented here indicates that when utilizing a tibia-first gap balancing technique, small deviations outside of traditional ±3°alignment boundaries did not negatively affect KOOS or UCLA outcomes, indicating balance may have a stronger link to patient outcome than alignment.

The Effects of Resection Technique on Implant Migration in Single Radius Posterior-Stabilized Total Knee Replacement

2018 ◽  
Vol 33 (01) ◽  
pp. 078-083
Author(s):  
Matthew G. Teeter ◽  
Kevin Perry ◽  
Xunhua Yuan ◽  
James L. Howard ◽  
Brent A. Lanting
Keyword(s):  
Total Knee Replacement ◽  
Femoral Component ◽  
Knee Replacement ◽  
Tibial Component ◽  
Posterior Stabilized ◽  
Gap Balancing ◽  
Measured Resection ◽  
Total Knee ◽  
Single Radius ◽  
Component Migration

AbstractThe purpose of the present study was to measure the effects of gap balancing and resection techniques on migration of a single total knee replacement implant design. A total of 23 patients (24 knees) were recruited on referral to either a surgeon performing gap balancing or a surgeon performing measured resection and followed prospectively. All patients received a fixed bearing, posterior stabilized total knee replacement implant of a single radius femoral component design with cement fixation, and all aspects of care outside of resection technique were identical. Patients underwent radiostereometric analysis (RSA) at 2 weeks (baseline), 6 weeks, 3 months, 6 months, 1 year, and 2 years. Migration of the tibial and femoral components was compared between groups. Tibial component migration was greater at 2 years in the gap balancing group (mean difference = 0.336 mm, p = 0.036), but there was no difference at 1 year. One measured resection and three gap balancing tibial components demonstrated continuous migration > 0.2 mm between years 1 and 2. There was no difference in femoral component migration. Small differences in tibial component migration were found between the gap balancing and measured resection techniques. However, comparing the migration to established predictive thresholds for long-term loosening risk, implants performed with both techniques were found to have equally low revision risk.

Navigation-Assisted Total Knee Arthroplasty for a Valgus Knee Improves Limb and Femoral Component Alignment

Orthopedics ◽  
2019 ◽  
Vol 42 (2) ◽  
pp. e253-e259 ◽  
Author(s):  
Sung-Sahn Lee ◽  
Kyeu-Back Kwon ◽  
Yong-In Lee ◽  
Young-Wan Moon
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Valgus Knee ◽  
Component Alignment ◽  
Total Knee

scholarly journals Retraction Note: Effect of sagittal femoral component alignment on biomechanics after mobile-bearing total knee arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong-Gon Koh ◽  
Jin-Ah Lee ◽  
Hwa-Yong Lee ◽  
Dong-Suk Suh ◽  
Hyo-Jeong Kim ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Femoral Component ◽  
Knee Arthroplasty ◽  
Mobile Bearing ◽  
Component Alignment ◽  
Total Knee ◽  
Retraction Notice

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s13018-019-1458-5.

Gap-Balancing versus Measured Resection Technique in Total Knee Arthroplasty: A Comparison Study

2017 ◽  
Vol 31 (01) ◽  
pp. 013-016 ◽  
Author(s):  
Jessica Churchill ◽  
Anton Khlopas ◽  
Assem Sultan ◽  
Steven Harwin ◽  
Michael Mont
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Component Alignment ◽  
Gap Balancing ◽  
Pain Scores ◽  
Measured Resection ◽  
Total Knee ◽  
The Mean ◽  
Ks Function

AbstractProper femoral component alignment in the axial plane during total knee arthroplasty (TKA) depends on accurate bone cuts and soft tissue balancing. Two methods that are used to achieve this are “measured resection” and “gap balancing.” However, a controversy exists as to which method is more accurate and leads to better outcomes. Therefore, the purpose of this study was to evaluate: (1) implant survivorship, (2) patient outcomes, (3) complications, and (4) radiographic analysis comparing patients who underwent TKA with either gap-balancing or measured resection techniques. A total of 214 consecutive patients (221 knees) underwent primary TKA by a single surgeon between 2011 and 2012. Component alignment was achieved by using measured resection in 116 knees and gap balancing was used in 105 knees. The patients had a mean age of 66 years (range, 44–86 years) and a mean body mass index of 32 kg/m2 (range, 22–52 kg/m2). Patient range-of-motion (ROM) and Knee Society (KS) function and pain scores, and radiographic assessment, were assessed preoperatively and postoperatively at ∼6 weeks, 3 months, 1 year, and then annually. The mean follow-up time was 3 years. A Kaplan–Meier's analysis was performed to calculate the survivorship. The aseptic survivorship was 98% in both the measured resection and gap-balancing groups. The mean ROM was not significantly different between the measured resection and gap-balancing groups (123 vs. 123 degrees, p = 0.990). There were no significant differences between the two groups in terms of the KS function scores (86 vs. 85 points, p = 0.829) or the KS pain scores (93 vs. 92 points, p = 0.425). Otherwise, the radiographic evaluation at latest follow-up did not demonstrate any evidence of progressive radiolucencies or loosening, of any prosthesis. The results of this study found that at a mean follow-up of 3 years, both the measured resection and gap-balancing techniques achieved excellent survivorship and postoperative outcomes. This demonstrates that both methods can be used to achieve accurate femoral component alignment with similar short-term outcomes.

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