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Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty

Sensor technology was introduced to intraoperatively analyse the differential pressure between the medial and lateral compartments of the knee during primary TKA using a sensor to assess if further balancing procedures are needed to achieve a “balanced” knee. The prognostic role of epidemiological a...

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Autores principales: Sabatini, Luigi, Bosco, Francesco, Barberis, Luca, Camazzola, Daniele, Bistolfi, Alessandro, Risitano, Salvatore, Massè, Alessandro, Indelli, Pier Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399549/
https://www.ncbi.nlm.nih.gov/pubmed/34450869
http://dx.doi.org/10.3390/s21165427
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author Sabatini, Luigi
Bosco, Francesco
Barberis, Luca
Camazzola, Daniele
Bistolfi, Alessandro
Risitano, Salvatore
Massè, Alessandro
Indelli, Pier Francesco
author_facet Sabatini, Luigi
Bosco, Francesco
Barberis, Luca
Camazzola, Daniele
Bistolfi, Alessandro
Risitano, Salvatore
Massè, Alessandro
Indelli, Pier Francesco
author_sort Sabatini, Luigi
collection PubMed
description Sensor technology was introduced to intraoperatively analyse the differential pressure between the medial and lateral compartments of the knee during primary TKA using a sensor to assess if further balancing procedures are needed to achieve a “balanced” knee. The prognostic role of epidemiological and radiological parameters was also analysed. A consecutive series of 21 patients with primary knee osteoarthritis were enrolled and programmed for TKA in our unit between 1 September 2020 and 31 March 2021. The VERASENSE Knee System (OrthoSensor Inc., Dania Beach, FL, USA) has been proposed as an instrument that quantifies the differential pressure between the compartments of the knee intraoperatively throughout the full range of motion during primary TKA, designed with a J-curve anatomical femoral design and a PS “medially congruent” polyethylene insert. Thirteen patients (61.90%) showed a “balanced” knee, and eight patients (38.10%) showed an intra-operative “unbalanced” knee and required additional procedures. A total of 13 additional balancing procedures were performed. At the end of surgical knee procedures, a quantitatively balanced knee was obtained in all patients. In addition, a correlation was found between the compartment pressure of phase I and phase II at 10° of flexion and higher absolute pressures were found in the medial compartment than in the lateral compartment in each ROM degree investigated. Moreover, those pressure values showed a trend to decrease with the increase in flexion degrees in both compartments. The “Kinetic Tracking” function displays the knee’s dynamic motion through the full ROM to evaluate joint kinetics. The obtained kinetic traces reproduced the knee’s medial pivot and femoral rollback, mimicking natural knee biomechanics. Moreover, we reported a statistically significant correlation between the need for soft tissue or bone resection rebalancing and severity of the initial coronal deformity (>10°) and a preoperative JLCA value >2°. The use of quantitative sensor-guided pressure evaluation during TKA leads to a more reproducible “balanced” knee. The surgeon, evaluating radiological parameters before surgery, may anticipate difficulties in knee balance and require those devices to achieve the desired result objectively.
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spelling pubmed-83995492021-08-29 Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty Sabatini, Luigi Bosco, Francesco Barberis, Luca Camazzola, Daniele Bistolfi, Alessandro Risitano, Salvatore Massè, Alessandro Indelli, Pier Francesco Sensors (Basel) Article Sensor technology was introduced to intraoperatively analyse the differential pressure between the medial and lateral compartments of the knee during primary TKA using a sensor to assess if further balancing procedures are needed to achieve a “balanced” knee. The prognostic role of epidemiological and radiological parameters was also analysed. A consecutive series of 21 patients with primary knee osteoarthritis were enrolled and programmed for TKA in our unit between 1 September 2020 and 31 March 2021. The VERASENSE Knee System (OrthoSensor Inc., Dania Beach, FL, USA) has been proposed as an instrument that quantifies the differential pressure between the compartments of the knee intraoperatively throughout the full range of motion during primary TKA, designed with a J-curve anatomical femoral design and a PS “medially congruent” polyethylene insert. Thirteen patients (61.90%) showed a “balanced” knee, and eight patients (38.10%) showed an intra-operative “unbalanced” knee and required additional procedures. A total of 13 additional balancing procedures were performed. At the end of surgical knee procedures, a quantitatively balanced knee was obtained in all patients. In addition, a correlation was found between the compartment pressure of phase I and phase II at 10° of flexion and higher absolute pressures were found in the medial compartment than in the lateral compartment in each ROM degree investigated. Moreover, those pressure values showed a trend to decrease with the increase in flexion degrees in both compartments. The “Kinetic Tracking” function displays the knee’s dynamic motion through the full ROM to evaluate joint kinetics. The obtained kinetic traces reproduced the knee’s medial pivot and femoral rollback, mimicking natural knee biomechanics. Moreover, we reported a statistically significant correlation between the need for soft tissue or bone resection rebalancing and severity of the initial coronal deformity (>10°) and a preoperative JLCA value >2°. The use of quantitative sensor-guided pressure evaluation during TKA leads to a more reproducible “balanced” knee. The surgeon, evaluating radiological parameters before surgery, may anticipate difficulties in knee balance and require those devices to achieve the desired result objectively. MDPI 2021-08-11 /pmc/articles/PMC8399549/ /pubmed/34450869 http://dx.doi.org/10.3390/s21165427 Text en © 2021 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
Sabatini, Luigi
Bosco, Francesco
Barberis, Luca
Camazzola, Daniele
Bistolfi, Alessandro
Risitano, Salvatore
Massè, Alessandro
Indelli, Pier Francesco
Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title_full Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title_fullStr Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title_full_unstemmed Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title_short Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty
title_sort kinetic sensors for ligament balance and kinematic evaluation in anatomic bi-cruciate stabilized total knee arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8399549/
https://www.ncbi.nlm.nih.gov/pubmed/34450869
http://dx.doi.org/10.3390/s21165427
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