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Lookup NU author(s): Dr Alasdair Blain, Lee Longstaff, Professor David Deehan
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Purpose Accurate soft tissue balance must be achieved to improve functional outcome after total knee arthroplasty (TKA). Sensor-integrated tibial trials have been introduced that allow real-time measurement of tibiofemoral kinematics during TKA. This study examined the interplay between tibiofemoral force and laxity, under defined intraoperative conditions, so as to quantify the kinematic behaviour of the CR femoral single-radius knee. Methods TKA was undertaken in eight loaded cadaveric specimens. Computer navigation in combination with sensor data defined laxity and tibiofemoral contact force, respectively, during manual laxity testing. Fixed-effect linear modelling allowed quantification of the effect for flexion angle, direction of movement and TKA implantation upon the knee. Results An inverse relationship between laxity and contact force was demonstrated. With flexion, laxity increased as contact force decreased under manual stress. Change in laxity was significant beyond 30° for coronal plane laxity and beyond 60° for rotatory laxity (p < 0.01). Rotational stress in mid-flexion demonstrated the greatest mismatch in inter-compartmental forces. Contact point position over the tibial sensor demonstrated paradoxical roll-forward with knee flexion. Conclusion Traditional balancing techniques may not reliably equate to uniform laxity or contact forces across the tibiofemoral joint through a range of flexion and argue for the role of per-operative sensor use to aid final balancing of the knee.
Author(s): Manning WA, Ghosh K, Blain A, Longstaff L, Deehan DJ
Publication type: Article
Publication status: Published
Journal: Knee Surgery, Sports Traumatology, Arthroscopy
Year: 2017
Volume: 25
Issue: 6
Pages: 1669-1677
Print publication date: 01/06/2017
Online publication date: 31/03/2016
Acceptance date: 14/03/2016
ISSN (print): 0942-2056
ISSN (electronic): 1433-7347
Publisher: Springer Verlag
URL: https://doi.org/10.1007/s00167-016-4093-2
DOI: 10.1007/s00167-016-4093-2
PubMed id: 27034084
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