Cargando…

Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing

Robotic arm–assisted total knee arthroplasty (TKA) involves a pre-resection gap balancing technique to obtain the desired gap. However, the expected gap may change owing to the soft-tissue release effect of unreachable osteophytes. This study evaluated the effect of unreachable osteophytes of the po...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Jong Hwa, Jung, Ho Jung, Lee, Joon Kyu, Hwang, Ji Hyo, Kim, Joong Il
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531677/
https://www.ncbi.nlm.nih.gov/pubmed/37762920
http://dx.doi.org/10.3390/jcm12185980
_version_ 1785111775603064832
author Lee, Jong Hwa
Jung, Ho Jung
Lee, Joon Kyu
Hwang, Ji Hyo
Kim, Joong Il
author_facet Lee, Jong Hwa
Jung, Ho Jung
Lee, Joon Kyu
Hwang, Ji Hyo
Kim, Joong Il
author_sort Lee, Jong Hwa
collection PubMed
description Robotic arm–assisted total knee arthroplasty (TKA) involves a pre-resection gap balancing technique to obtain the desired gap. However, the expected gap may change owing to the soft-tissue release effect of unreachable osteophytes. This study evaluated the effect of unreachable osteophytes of the posterior medial femoral condyle on gap changes following bony resection. We retrospectively analysed 129 robotic arm–assisted TKAs performed for varus knee osteoarthritis. Knees were classified according to the size of osteophytes on the posterior medial femoral condyle using preoperative computed tomography measurement. After the removal of reachable osteophytes, the robotic system measured pre- and post-resection medial extension (ME), lateral extension (LE), medial flexion (MF), and lateral flexion (LF) gaps. No extension gap changes were observed for 25 (19.4%), and no flexion gap changes were observed 41 (31.8%) knees, following bone cuts. ME, LE, MF, and LF gaps increased with the osteophyte size (p < 0.05). For osteophytes <10 mm, all the gaps increased symmetrically. However, for osteophytes >10 mm, the ME gap increased asymmetrically more than LE, MF, and LF gaps (p < 0.05). The gap changes due to bony resection were correlated to the osteophyte sizes of the posterior medial femoral condyle. Surgeons should plan a slightly tight medial extension gap to attain the desired gaps for >10 mm osteophytes.
format Online
Article
Text
id pubmed-10531677
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-105316772023-09-28 Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing Lee, Jong Hwa Jung, Ho Jung Lee, Joon Kyu Hwang, Ji Hyo Kim, Joong Il J Clin Med Article Robotic arm–assisted total knee arthroplasty (TKA) involves a pre-resection gap balancing technique to obtain the desired gap. However, the expected gap may change owing to the soft-tissue release effect of unreachable osteophytes. This study evaluated the effect of unreachable osteophytes of the posterior medial femoral condyle on gap changes following bony resection. We retrospectively analysed 129 robotic arm–assisted TKAs performed for varus knee osteoarthritis. Knees were classified according to the size of osteophytes on the posterior medial femoral condyle using preoperative computed tomography measurement. After the removal of reachable osteophytes, the robotic system measured pre- and post-resection medial extension (ME), lateral extension (LE), medial flexion (MF), and lateral flexion (LF) gaps. No extension gap changes were observed for 25 (19.4%), and no flexion gap changes were observed 41 (31.8%) knees, following bone cuts. ME, LE, MF, and LF gaps increased with the osteophyte size (p < 0.05). For osteophytes <10 mm, all the gaps increased symmetrically. However, for osteophytes >10 mm, the ME gap increased asymmetrically more than LE, MF, and LF gaps (p < 0.05). The gap changes due to bony resection were correlated to the osteophyte sizes of the posterior medial femoral condyle. Surgeons should plan a slightly tight medial extension gap to attain the desired gaps for >10 mm osteophytes. MDPI 2023-09-15 /pmc/articles/PMC10531677/ /pubmed/37762920 http://dx.doi.org/10.3390/jcm12185980 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Jong Hwa
Jung, Ho Jung
Lee, Joon Kyu
Hwang, Ji Hyo
Kim, Joong Il
Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title_full Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title_fullStr Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title_full_unstemmed Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title_short Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing
title_sort large osteophytes over 10 mm at posterior medial femoral condyle can lead to asymmetric extension gap following bony resection in robotic arm–assisted total knee arthroplasty with pre-resection gap balancing
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531677/
https://www.ncbi.nlm.nih.gov/pubmed/37762920
http://dx.doi.org/10.3390/jcm12185980
work_keys_str_mv AT leejonghwa largeosteophytesover10mmatposteriormedialfemoralcondylecanleadtoasymmetricextensiongapfollowingbonyresectioninroboticarmassistedtotalkneearthroplastywithpreresectiongapbalancing
AT junghojung largeosteophytesover10mmatposteriormedialfemoralcondylecanleadtoasymmetricextensiongapfollowingbonyresectioninroboticarmassistedtotalkneearthroplastywithpreresectiongapbalancing
AT leejoonkyu largeosteophytesover10mmatposteriormedialfemoralcondylecanleadtoasymmetricextensiongapfollowingbonyresectioninroboticarmassistedtotalkneearthroplastywithpreresectiongapbalancing
AT hwangjihyo largeosteophytesover10mmatposteriormedialfemoralcondylecanleadtoasymmetricextensiongapfollowingbonyresectioninroboticarmassistedtotalkneearthroplastywithpreresectiongapbalancing
AT kimjoongil largeosteophytesover10mmatposteriormedialfemoralcondylecanleadtoasymmetricextensiongapfollowingbonyresectioninroboticarmassistedtotalkneearthroplastywithpreresectiongapbalancing