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Archives of Orthopaedic and Trauma Surgery

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01-05-2017 | Knee Arthroplasty

Changes of posterior condylar offset results in midflexion instability in single-radius total knee arthroplasty

Authors: Georg Matziolis, Steffen Brodt, Christoph Windisch, Eric Roehner

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 5/2017

Abstract

Introduction

There is no algorithm for the management of joint stability in midflexion up to now. Change in the joint line (JL) is considered to be the primary cause, although it only determines the extension gap. The purpose of this study was to determine the influence of the posterior condylar offsets (PCO), which defines the flexion gap, on midflexion instability.

Materials and methods

Forty-two knee joints (38 patients) were included in this study, patients undergoing navigated total knee arthroplasty due to primary osteoarthritis of the knee. Changes in the JL and the PCO were determined from the navigation data. A gap tensioning device was used to determine the width of the joint gap at −5°, 0°, 30° and 60° intraoperatively.

Results

Within a range between 5 mm proximalization and 2 mm distalization, the JL had no influence on stability in midflexion. In contrast to this, both an increase and a decrease in PCO led to midflexion instability (R = 0.361, p = 0.019). In 16 cases (38%), the PCO was changed by more than 2 mm. This led to a midflexion instability of more than 2 mm in seven of these cases (44%).

Conclusions

Whereas the joint line can be displaced by up to 5 mm without measurable changes in joint stability, reconstruction of the posterior offset within a tight range of 2 mm is necessary to avoid midflexion instability.

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Title: Changes of posterior condylar offset results in midflexion instability in single-radius total knee arthroplasty
Authors: Georg Matziolis
Steffen Brodt
Christoph Windisch
Eric Roehner
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 5/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2671-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Changes of posterior condylar offset results in midflexion instability in single-radius total knee arthroplasty

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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