Cargando…

Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA

As the conformity of a medial ball-in-socket total knee arthroplasty (TKA) provides intrinsic anterior-posterior (A-P) stability, surgeons cannot rely on the manual examination of sagittal laxity to identify the optimal insert thickness. Instead, the present study determined whether measuring tibial...

Descripción completa

Detalles Bibliográficos
Autores principales: Nedopil, Alexander J., Howell, Stephen M., Hull, Maury L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500699/
https://www.ncbi.nlm.nih.gov/pubmed/36143212
http://dx.doi.org/10.3390/jpm12091427
_version_ 1784795285297299456
author Nedopil, Alexander J.
Howell, Stephen M.
Hull, Maury L.
author_facet Nedopil, Alexander J.
Howell, Stephen M.
Hull, Maury L.
author_sort Nedopil, Alexander J.
collection PubMed
description As the conformity of a medial ball-in-socket total knee arthroplasty (TKA) provides intrinsic anterior-posterior (A-P) stability, surgeons cannot rely on the manual examination of sagittal laxity to identify the optimal insert thickness. Instead, the present study determined whether measuring tibial axial orientation in extension and 90° flexion with an insert goniometer could identify the optimal thickness that, when implanted, provides high postoperative function. In twenty-two patients that underwent unrestricted caliper-verified kinematic alignment (KA) with a PCL retaining implant, two surgeons measured tibial orientation in extension and 90° flexion with 10, 11, 12, and 13 mm thick insert goniometers. Each TKA had one insert thickness that restored either the maximum external tibial orientation in extension, the maximum internal tibial orientation at 90° flexion, or both relative to 1 mm thinner and thicker inserts. In addition, the 6-month median [interquartile range] Forgotten Joint Score of 73 (54–87) and Oxford Knee Score of 42 (38–45) indicated high satisfaction and function. In conclusion, surgeons using a medial ball-in-socket TKA design can measure external tibial orientation in extension and internal tibial orientation at 90° flexion with an insert goniometer. Furthermore, implanting an insert with the thickness that provided the maximum orientation values resulted in high postoperative function, thereby personalizing PCL tension.
format Online
Article
Text
id pubmed-9500699
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95006992022-09-24 Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA Nedopil, Alexander J. Howell, Stephen M. Hull, Maury L. J Pers Med Article As the conformity of a medial ball-in-socket total knee arthroplasty (TKA) provides intrinsic anterior-posterior (A-P) stability, surgeons cannot rely on the manual examination of sagittal laxity to identify the optimal insert thickness. Instead, the present study determined whether measuring tibial axial orientation in extension and 90° flexion with an insert goniometer could identify the optimal thickness that, when implanted, provides high postoperative function. In twenty-two patients that underwent unrestricted caliper-verified kinematic alignment (KA) with a PCL retaining implant, two surgeons measured tibial orientation in extension and 90° flexion with 10, 11, 12, and 13 mm thick insert goniometers. Each TKA had one insert thickness that restored either the maximum external tibial orientation in extension, the maximum internal tibial orientation at 90° flexion, or both relative to 1 mm thinner and thicker inserts. In addition, the 6-month median [interquartile range] Forgotten Joint Score of 73 (54–87) and Oxford Knee Score of 42 (38–45) indicated high satisfaction and function. In conclusion, surgeons using a medial ball-in-socket TKA design can measure external tibial orientation in extension and internal tibial orientation at 90° flexion with an insert goniometer. Furthermore, implanting an insert with the thickness that provided the maximum orientation values resulted in high postoperative function, thereby personalizing PCL tension. MDPI 2022-08-31 /pmc/articles/PMC9500699/ /pubmed/36143212 http://dx.doi.org/10.3390/jpm12091427 Text en © 2022 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
Nedopil, Alexander J.
Howell, Stephen M.
Hull, Maury L.
Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title_full Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title_fullStr Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title_full_unstemmed Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title_short Measurement of Tibial Orientation Helps Select the Optimal Insert Thickness to Personalize PCL Tension in a Medial Ball-in-Socket TKA
title_sort measurement of tibial orientation helps select the optimal insert thickness to personalize pcl tension in a medial ball-in-socket tka
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500699/
https://www.ncbi.nlm.nih.gov/pubmed/36143212
http://dx.doi.org/10.3390/jpm12091427
work_keys_str_mv AT nedopilalexanderj measurementoftibialorientationhelpsselecttheoptimalinsertthicknesstopersonalizepcltensioninamedialballinsockettka
AT howellstephenm measurementoftibialorientationhelpsselecttheoptimalinsertthicknesstopersonalizepcltensioninamedialballinsockettka
AT hullmauryl measurementoftibialorientationhelpsselecttheoptimalinsertthicknesstopersonalizepcltensioninamedialballinsockettka