scholarly journals Can Knee Stability at 0 and 90 Degrees Accurately Predict Mid-Flexion Stability in TKA

10.29007/q4d5 ◽  
2020 ◽  
Author(s):  
Bertrand Kaper
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Balance ◽  
Knee Stability ◽  
Robotic Assisted

The goal of this study was to utilize the NAVIO robotic-assisted (RA)-TKA technique to assess whether a knee that is well-balanced at 0 and 90 is also well balanced in mid-flexion. Using a 3mm threshold to define soft-tissue balance, results demonstrated that 11.5% of knees studied could be expected to be unstable in the mid-flexion arc (15-75) despite being well-balanced at the static poses at 0 and 90.

scholarly journals Soft Tissue Imbalance Resulting from a Simulated Measured Resection Model as Predicted by the Use of Robotic-Assisted Total Knee Arthroplasty Technology

10.29007/mrbg ◽  
2020 ◽  
Author(s):  
Bertrand Kaper
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Surgical Technique ◽  
Knee Arthroplasty ◽  
Soft Tissue Balance ◽  
Robotic Assisted ◽  
Accuracy And Precision ◽  
Measured Resection ◽  
Soft Tissue Laxity ◽  
Total Knee

In this study, patients undergoing RA-TKA were critically assessed to understand the accuracy and precision of a simulated MR model used historically in manually instrumented TKA surgery. Using a 3mm threshold of soft-tissue laxity, knees were identified that would have been expected to require the application of a “reactive” CI-TKA surgical technique to achieve adequate soft-tissue balance.

scholarly journals Accuracy of Soft Tissue Balancing in Robotic-Assisted Measured-Resection TKA Using a Robotic Distraction Tool

10.29007/h8kn ◽  
2019 ◽  
Author(s):  
Jan Koenig ◽  
Sami Shalhoub ◽  
Eric Chen ◽  
Christopher Plaskos
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Measurement Data ◽  
Soft Tissue Balance ◽  
Maximum Difference ◽  
Robotic Assisted ◽  
Soft Tissue Balancing ◽  
Gap Measurement ◽  
Measured Resection ◽  
Patient Reported

Achieving proper soft tissue balance during total knee arthroplasty (TKA) can reduce post- operative instability and stiffness as well as improve patient reported outcomes. The objective of this study was to compare final intra-operative coronal balance throughout the knee range of motion in navigated robotic-assisted TKA when performed with quantifiable feedback from a robotic ligament tensioning tool versus with standard trials and navigation measurements alone.The study included a prospective cohort of 52 patients undergoing robotic-assisted TKA using a measured resection technique. The cohort was divided into two sequential groups: a non-sensor-assisted group (n=25) and a subsequent sensor-assisted group (n=27). Once bony cuts and soft tissue balancing was performed in the non-sensor cohort, the final tibiofemoral gaps were measured throughout the knee range of motion using a robotic-assisted tensioner with the surgeon blinded to the measurements. For the sensor cohort, the surgeon preformed soft-tissue releases or re-cuts in order to balance the knee using the gap measurement data from the robotic tensioner. The robotic-assisted tensioner was then used to measure the final medial and lateral gap measurements.The average mediolateral gap difference throughout the range of flexion was 1.9 ± 0.7 mm with maximum difference of 7.8 mm for the non-sensor cohort. The sensor cohort had an average mediolateral difference of 1.5 ± 0.6 mm and a maximum difference of 3.8 mm. The difference between the two groups was statistically significant from 60 to 90 degrees of flexion. 38-41% of knees were balanced to within 1 mm mediolaterally in the non-sensor group compared to 48-70% for the sensor group when measured at various flexion angles. 65-76% of knees were balanced to within 2 mm for the non-sensor group compared to 78-86% for the sensor-assisted group. The number of knees requiring subsequent soft tissue releases was similar in each group. Soft tissue balancing with the aid of a robotic tensioning tool resulted in significantly more accurate soft tissue balance than when using navigation measurements and standard trials alone in this single surgeon study.

scholarly journals True Kinematic Alignment Is Applicable in 44% of Patients Applying Restrictive Indication Criteria—A Retrospective Analysis of 111 TKA Using Robotic Assistance

2021 ◽  
Vol 11 (7) ◽  
pp. 662
Author(s):  
Kim Huber ◽  
Bernhard Christen ◽  
Sarah Calliess ◽  
Tilman Calliess
Keyword(s):  
Soft Tissue ◽  
Retrospective Analysis ◽  
Patient Specific ◽  
Kinematic Alignment ◽  
Postoperative Phase ◽  
Robotic Assistance ◽  
Component Position ◽  
Joint Stability ◽  
Robotic Assisted ◽  
Primary Tkas

Introduction: Image-based robotic assistance appears to be a promising tool for individualizing alignment in total knee arthroplasty (TKA). The patient-specific model of the knee enables a preoperative 3D planning of component position. Adjustments to the individual soft-tissue situation can be done intraoperatively. Based on this, we have established a standardized workflow to implement the idea of kinematic alignment (KA) for robotic-assisted TKA. In addition, we have defined limits for its use. If these limits are reached, we switch to a restricted KA (rKA). The aim of the study was to evaluate (1) in what percentage of patients a true KA or an rKA is applicable, (2) whether there were differences regarding knee phenotypes, and (3) what the differences of philosophies in terms of component position, joint stability, and early patient outcome were. Methods: The study included a retrospective analysis of 111 robotic-assisted primary TKAs. Based on preoperative long leg standing radiographs, the patients were categorized into a varus, valgus, or neutral subgroup. Initially, all patients were planned for KA TKA. When the defined safe zone had been exceeded, adjustments to an rKA were made. Intraoperatively, the alignment of the components and joint gaps were recorded by robotic software. Results and conclusion: With our indication for TKA and the defined boundaries, “only” 44% of the patients were suitable for a true KA with no adjustments or soft tissue releases. In the varus group, it was about 70%, whereas it was 0% in the valgus group and 25% in the neutral alignment group. Thus, significant differences with regard to knee morphotypes were evident. In the KA group, a more physiological knee balance reconstructing the trapezoidal flexion gap (+2 mm on average laterally) was seen as well as a closer reconstruction of the surface anatomy and joint line in all dimensions compared to rKA. This resulted in a higher improvement in the collected outcome scores in favor of KA in the very early postoperative phase.

Soft Tissue Balance Changes Depending on Joint Distraction Force in Total Knee Arthroplasty

2014 ◽  
Vol 29 (3) ◽  
pp. 520-524 ◽  
Author(s):  
Kanto Nagai ◽  
Hirotsugu Muratsu ◽  
Tomoyuki Matsumoto ◽  
Hidetoshi Miya ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Balance ◽  
Joint Distraction ◽  
Total Knee ◽  
Distraction Force

Periprosthetic Soft Tissue Balance in Hip Arthroplasty

2014 ◽  
pp. 1-6
Author(s):  
Caglar Yilgor ◽  
Gokhan Demirkiran ◽  
Omur Caglar
Keyword(s):  
Soft Tissue ◽  
Hip Arthroplasty ◽  
Soft Tissue Balance

Soft-Tissue Balance in Short and Straight Stem Total Hip Arthroplasty

Orthopedics ◽  
2015 ◽  
Vol 38 (3) ◽  
pp. S14-S20 ◽  
Author(s):  
Henning Windhagen ◽  
Andra Chincisan ◽  
Hon Fai Choi ◽  
Fritz Thorey
Keyword(s):  
Soft Tissue ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Soft Tissue Balance ◽  
Total Hip ◽  
Straight Stem

scholarly journals Complex foot deformities associated with lower limb deformities: a new therapeutic strategy for simultaneous correction using Ilizarov procedure together with osteotomy and soft tissue release

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Qin Boquan ◽  
Ren Yi ◽  
Gan Tingjiang ◽  
Liu Xi ◽  
Zhang Hui
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Therapeutic Strategy ◽  
Case Series ◽  
Soft Tissue Balance ◽  
Soft Tissue Release ◽  
Osteotomy Site ◽  
Foot Deformities ◽  
Limb Deformities ◽  
The Mean

Abstract Aim The aim of the current study is to introduce a new therapeutic strategy for simultaneous correction of complex foot deformities (CFD) and the associated lower limb deformities (LLD) by using Ilizarov technique with osteotomy and soft tissue procedure and to report its early clinical results. Methods A retrospective review of CFD associated with LLD simultaneous correction utilizing the Ilizarov procedure together with osteotomy and soft tissue balance from 2015 to 2019 was conducted. Results Thirty-two patients were followed for an average of 42.8 months. The mean external fixation time (EFT) was 6.5 months. The mean healing index (HI) was 1.7 months/cm. At the time of fixator removal, plantigrade feet were achieved in all patient and lower limb deformities were corrected. No recurrence of the deformities occurred. The mean LLRS AIM score was improved from 7.5 to 0.3. At the final follow-up, the ASAMI-Paley score was graded as excellent in all limbs in the aspect of bone results, and functional results were defined as excellent in 29 (90.6%) limbs and good in 3 (9.4%) limbs. The mean modified Dimeglio score was significantly improved from 7.2 to 1.3. No deep infection of the osteotomy site or nonunion was noted in the current study. Conclusion The therapeutic strategy by using the Ilizarov procedure together with osteotomy and soft tissue balance is a safe and effective way to simultaneously correct CFD and LLD. Level of evidence Level IV, retrospective case series

scholarly journals Less iatrogenic soft-tissue damage utilizing robotic-assisted total knee arthroplasty when compared with a manual approach

2019 ◽  
Vol 8 (10) ◽  
pp. 495-501 ◽  
Author(s):  
Emily L. Hampp ◽  
Nipun Sodhi ◽  
Laura Scholl ◽  
Matthew E. Deren ◽  
Zachary Yenna ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Tissue Damage ◽  
Soft Tissues ◽  
Soft Tissue Damage ◽  
Anatomical Structures ◽  
Cruciate Retaining ◽  
Robotic Assisted ◽  
Total Knee

Objectives The use of the haptically bounded saw blades in robotic-assisted total knee arthroplasty (RTKA) can potentially help to limit surrounding soft-tissue injuries. However, there are limited data characterizing these injuries for cruciate-retaining (CR) TKA with the use of this technique. The objective of this cadaver study was to compare the extent of soft-tissue damage sustained through a robotic-assisted, haptically guided TKA (RATKA) versus a manual TKA (MTKA) approach. Methods A total of 12 fresh-frozen pelvis-to-toe cadaver specimens were included. Four surgeons each prepared three RATKA and three MTKA specimens for cruciate-retaining TKAs. A RATKA was performed on one knee and a MTKA on the other. Postoperatively, two additional surgeons assessed and graded damage to 14 key anatomical structures in a blinded manner. Kruskal–Wallis hypothesis tests were performed to assess statistical differences in soft-tissue damage between RATKA and MTKA cases. Results Significantly less damage occurred to the PCLs in the RATKA versus the MTKA specimens (p < 0.001). RATKA specimens had non-significantly less damage to the deep medial collateral ligaments (p = 0.149), iliotibial bands (p = 0.580), poplitei (p = 0.248), and patellar ligaments (p = 0.317). The remaining anatomical structures had minimal soft-tissue damage in all MTKA and RATKA specimens. Conclusion The results of this study indicate that less soft-tissue damage may occur when utilizing RATKA compared with MTKA. These findings are likely due to the enhanced preoperative planning with the robotic software, the real-time intraoperative feedback, and the haptically bounded saw blade, all of which may help protect the surrounding soft tissues and ligaments. Cite this article: Bone Joint Res 2019;8:495–501. DOI: 10.1302/2046-3758.810.BJR-2019-0129.R1.

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