Navigation-based analysis of associations between intraoperative joint gap and mediolateral laxity in total knee arthroplasty |
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| Affiliation: | 1. Department of Molecular Medicine Arthritis Research, The Scripps Research Institute, CA, USA;2. Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan;3. Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Osaka, Japan;4. Department of Information Systems, Faculty of Engineering, Saitama Institute of Technology, Saitama, Japan;5. Department of Orthopaedic Surgery, Osaka Medical Center, Osaka, Japan;6. Shiley Center for Orthopaedic Research and Education at Scripps Clinic, CA, USA;1. Dept. Trauma Surgery, University Hospital Leuven, KU Leuven - University of Leuven, Leuven, Belgium;2. Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, the Netherlands;3. University of Groningen, University Medical Center Groningen, Department of Trauma Surgery, Groningen, the Netherlands;4. Klinik für Orthopädie und Unfallchirurgie, LUKS Luzern, Switzerland;5. VU Brussel - Free University of Brussels, Department of Orthopedics and Traumatology, Belgium;1. Second Department of Orthopaedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan;2. Department of Orthopaedic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan;3. Graduate School of Medical Technology and Health Welfare Sciences, Hiroshima International University, Hiroshima, Japan |
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| Abstract: | BackgroundNo data have demonstrated how joint gap measured under a distraction force is actually associated with mediolateral laxity evaluated under a varus–valgus force during total knee arthroplasty (TKA). This study aimed to investigate the correlations between them using a navigation system.MethodsA total of 113 primary navigated TKAs were included. After bone resection and soft-tissue balancing, the component gap was measured with a distraction force of 60 N and 80 N for both the medial and lateral compartment (i.e. a total of 120 N and 160 N) at 0°, 10°, 30°, 60°, 90°, and 120° knee flexion. After the final prosthetic implantation and capsule closure, mediolateral laxity under a maximum varus–valgus stress was recorded with image-free navigation at each knee flexion angle. The correlation between joint gap laxity (total differences between component gap and insert thickness in the medial and lateral compartment) and mediolateral laxity was analyzed using Spearman’s rank correlation coefficient.ResultsThe joint gap laxity under both distraction forces showed significant positive correlations with mediolateral laxity at 10°, 30°, 60°, and 90° flexion, whereas no correlation was observed at extension and 120° flexion. The correlations were stronger in gap measurement under 80 N than 60 N at all examined ranges. In patients with body mass indexes (BMIs) ≥ 30 kg/m2, the correlation became non-significant.ConclusionIntraoperative joint gap laxity was associated with mediolateral laxity after TKA, especially at mid-flexion angles. The factors weakening the correlations were a lower applied distraction force for gap measurement and a larger BMI. |
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| Keywords: | Total knee arthroplasty Component gap Mediolateral laxity Bicruciate stabilized total knee arthroplasty |
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