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01-03-2014 | Original Paper

Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique

Authors: Tomoyuki Matsumoto, Hirotsugu Muratsu, Yohei Kawakami, Koji Takayama, Kazunari Ishida, Takehiko Matsushita, Toshihiro Akisue, Kotaro Nishida, Ryosuke Kuroda, Masahiro Kurosaka

Published in: International Orthopaedics | Issue 3/2014

Abstract

Purpose

The purpose of this study was to prove the hypothesis that soft tissues are well balanced using the gap technique with a navigation system in cruciate-retaining (CR) and posterior-stabilised (PS) total knee arthroplasty (TKA), leading to better clinical outcomes compared with the measured-resection technique.

Methods

One hundred and thirty-five TKAs (90 CR and 45 PS) were performed in patients with varus-type osteoarthritis using the gap technique guided by the offset-type tensor and a navigation system. Soft-tissue balance (joint-component gap and ligament balance) were intraoperatively assessed with the tensor under 40 lb of joint-distraction force. The achievement in the equalised rectangular gap at extension and flexion was assessed and retrospectively compared with the previous series in which the measured-resection technique was used (20 CR and 100 PS TKAs). In addition, clinical outcomes, including range of motion and Knee Society Score were assessed at a minimum two year follow-up.

Results

In achieving equalised rectangular gaps at extension and flexion, CR TKAs met criteria in more cases [66.7 % (64/90) vs. 44.4 % (20/45) of PS TKA] with the gap technique, which was superior to that with the measured-resection technique [50.0 % (10/20) of CR TKA and 28.0 % (28/100) of PS TKA]. However, clinical outcomes showed no significant differences among groups at minimum two year follow-up.

Conclusions

The superiority of CR TKA with the gap technique in achieving equalised rectangular gaps at extension and flexion does not directly reflect two year postoperative clinical outcomes.

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Title: Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique
Authors: Tomoyuki Matsumoto
Hirotsugu Muratsu
Yohei Kawakami
Koji Takayama
Kazunari Ishida
Takehiko Matsushita
Toshihiro Akisue
Kotaro Nishida
Ryosuke Kuroda
Masahiro Kurosaka
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 3/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-013-2133-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Soft-tissue balancing in total knee arthroplasty: cruciate-retaining versus posterior-stabilised, and measured-resection versus gap technique

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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