How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment
To achieve a balanced total knee, various surgical corrections can be performed, while intra-operative sensors and surgical navigation provide quantitative, patient-specific feedback. To understand the impact of these corrections, this paper evaluates the quantitative impact of both soft tissue rele...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-01-01
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| Series: | Sensors |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1424-8220/21/3/700 |
| _version_ | 1797408959831736320 |
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| author | Ryan E. Moore Michael A. Conditt Martin W. Roche Matthias A. Verstraete |
| author_facet | Ryan E. Moore Michael A. Conditt Martin W. Roche Matthias A. Verstraete |
| author_sort | Ryan E. Moore |
| collection | DOAJ |
| description | To achieve a balanced total knee, various surgical corrections can be performed, while intra-operative sensors and surgical navigation provide quantitative, patient-specific feedback. To understand the impact of these corrections, this paper evaluates the quantitative impact of both soft tissue releases and bone recuts on knee balance and overall limb alignment. This was achieved by statistically analyzing the alignment and load readings before and after each surgical correction performed on 479 consecutive primary total knees. An average of three surgical corrections were required following the initial bone cuts to achieve a well aligned, balanced total knee. Various surgical corrections, such as an arcuate release or increasing the tibial polyethylene insert thickness, significantly affected the maximum terminal extension. The coronal alignment was significantly impacted by pie-crusting the MCL, adding varus to the tibia, or releasing the arcuate ligament or popliteus tendon. Each surgical correction also had a specific impact on the intra-articular loads in flexion and/or extension. A surgical algorithm is presented that helps achieve a well-balanced knee while maintaining the sagittal and coronal alignment within the desired boundaries. This analysis additionally indicated the significant effect that soft tissue adjustments can have on the limb alignment in both anatomical planes. |
| first_indexed | 2024-03-09T04:07:24Z |
| format | Article |
| id | doaj.art-12435d0c091a49968db5316ad7fc577f |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-09T04:07:24Z |
| publishDate | 2021-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-12435d0c091a49968db5316ad7fc577f2023-12-03T14:03:59ZengMDPI AGSensors1424-82202021-01-0121370010.3390/s21030700How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control AlignmentRyan E. Moore0Michael A. Conditt1Martin W. Roche2Matthias A. Verstraete3Coon Joint Replacement Institute: Adventist Health, St. Helena, CA 94574, USAOrthoSensor Inc., Dania Beach, FL 33004, USAHoly Cross Hospital, Fort Lauderdale, FL 33308, USADepartment of Structure and Repair, Ghent University, 9000 Ghent, BelgiumTo achieve a balanced total knee, various surgical corrections can be performed, while intra-operative sensors and surgical navigation provide quantitative, patient-specific feedback. To understand the impact of these corrections, this paper evaluates the quantitative impact of both soft tissue releases and bone recuts on knee balance and overall limb alignment. This was achieved by statistically analyzing the alignment and load readings before and after each surgical correction performed on 479 consecutive primary total knees. An average of three surgical corrections were required following the initial bone cuts to achieve a well aligned, balanced total knee. Various surgical corrections, such as an arcuate release or increasing the tibial polyethylene insert thickness, significantly affected the maximum terminal extension. The coronal alignment was significantly impacted by pie-crusting the MCL, adding varus to the tibia, or releasing the arcuate ligament or popliteus tendon. Each surgical correction also had a specific impact on the intra-articular loads in flexion and/or extension. A surgical algorithm is presented that helps achieve a well-balanced knee while maintaining the sagittal and coronal alignment within the desired boundaries. This analysis additionally indicated the significant effect that soft tissue adjustments can have on the limb alignment in both anatomical planes.https://www.mdpi.com/1424-8220/21/3/700balancingsurgical correctionssoft tissue releasesmechanical alignmenttotal knee arthroplasty |
| spellingShingle | Ryan E. Moore Michael A. Conditt Martin W. Roche Matthias A. Verstraete How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment Sensors balancing surgical corrections soft tissue releases mechanical alignment total knee arthroplasty |
| title | How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment |
| title_full | How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment |
| title_fullStr | How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment |
| title_full_unstemmed | How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment |
| title_short | How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment |
| title_sort | how to quantitatively balance a total knee a surgical algorithm to assure balance and control alignment |
| topic | balancing surgical corrections soft tissue releases mechanical alignment total knee arthroplasty |
| url | https://www.mdpi.com/1424-8220/21/3/700 |
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