Soft tissue balance measurement in anterior cruciate ligament-resected knee joint: cadaveric study as a model for cruciate-retaining total knee arthroplasty.
BACKGROUND
The soft tissue balancing procedure remains a difficult issue during total knee arthroplasty, as much depends on the surgeon's "feel." Although computer-assisted navigation technology has been attempting to evaluate the joint stability, we have no definitive answer to an ideal soft tissue balance of the knee joint. The purpose of the present study was to determine the soft tissue balance in an anterior cruciate ligament (ACL)-resected normal knee joint throughout the range of knee flexion, which may provide reference data for cruciate-retaining total knee arthroplasty (TKA).


METHODS
We investigated joint stability in 10 ACL-resected normal cadaver knees throughout the range of flexion under consistent joint distraction force using a specially developed tensioning device for TKA. We measured both medial and lateral joint gaps as the separation distance between the articular surfaces with 40 lb (18.7 kg) of joint distraction force.


RESULTS
Both medial and lateral joint gaps at 0 degrees of flexion were significantly smaller than those at other flexion angles. The medial joint gap was almost consistent during knee flexion; however, the lateral joint gap increased with knee flexion and showed a significantly larger value at 60 degrees-120 degrees of flexion than the medial joint gap.


CONCLUSIONS
These characteristics of joint stability in the ACL-resected normal knee need to be taken into consideration in soft tissue balancing during cruciate-retaining TKA.
Tanaka
Koichi
K
Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan.
Muratsu
Hirotsugu
H
Mizuno
Kiyonori
K
Kuroda
Ryosuke
R
Yoshiya
Shinichi
S
Kurosaka
Masahiro
M
D000368:Aged; D000369:Aged, 80 and over; D000070598:Anterior Cruciate Ligament Injuries; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D002102:Cadaver; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000502:physiology; D008297:Male; D016059:Range of Motion, Articular