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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...

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Detalles Bibliográficos
Autores principales: Moore, Ryan E., Conditt, Michael A., Roche, Martin W., Verstraete, Matthias A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864328/
https://www.ncbi.nlm.nih.gov/pubmed/33498576
http://dx.doi.org/10.3390/s21030700
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author Moore, Ryan E.
Conditt, Michael A.
Roche, Martin W.
Verstraete, Matthias A.
author_facet Moore, Ryan E.
Conditt, Michael A.
Roche, Martin W.
Verstraete, Matthias A.
author_sort Moore, Ryan E.
collection PubMed
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.
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spelling pubmed-78643282021-02-06 How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment Moore, Ryan E. Conditt, Michael A. Roche, Martin W. Verstraete, Matthias A. Sensors (Basel) Letter 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. MDPI 2021-01-20 /pmc/articles/PMC7864328/ /pubmed/33498576 http://dx.doi.org/10.3390/s21030700 Text en © 2021 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Letter
Moore, Ryan E.
Conditt, Michael A.
Roche, Martin W.
Verstraete, Matthias A.
How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment
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 Letter
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7864328/
https://www.ncbi.nlm.nih.gov/pubmed/33498576
http://dx.doi.org/10.3390/s21030700
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