Computer-assisted gap equalization in total knee arthroplasty.
This in vitro biomechanical study compared a conventional balancing technique in knee arthroplasty to a technique using computer assistance. The experimental technique used a soft tissue tensioner instrumented with computer-monitored load cells to quantify soft tissue tension. To assess outcome, a tibial load transducer measured medial and lateral compartment forces and tibial rotation. An electromagnetic tracking system quantified knee position under simulated muscle loading. The computer-assisted technique improved knee balance before insertion of components. However, once components were implanted, there was no difference in knee load balance between the 2 techniques. No correlation was shown between compartmental load balance and tibial rotation or mechanical axis misalignment. Although computer-assisted surgery may improve technical accuracy, further work is necessary to achieve an optimal final knee load balance.
Viskontas
Darius G
DG
Hand and Upper Limb Clinic, St. Joseph's Health Centre, University of Western, Ontario, London, Canada.
Skrinskas
Tomas V
TV
Johnson
James A
JA
King
Graham J
GJ
Winemaker
Mitchell J
MJ
Chess
David G
DG
D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D012399:Rotation; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000503:physiopathology; D016896:Treatment Outcome