title: Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty.
abstract: Medial release for varus knee is a key procedure to obtain appropriate soft tissue balance in total knee arthroplasty (TKA). The influence of semimembranosus release during cruciate-retaining (CR) TKA on knee kinematics and clinical outcomes were investigated in consecutive 50 patients (25: semimembranosus release group, 25: minimum release group) with moderate varus osteoarthritis using a navigation system. Semimembranosus release significantly reduced the amount of tibial internal rotation before bone cut and after all prostheses implanted. Despite of no significant differences in clinical scores between the groups, minimum release group exhibited significantly higher postoperative flexion angle compared to the semimembranosus release group. Minimal medial release with avoiding semimembranosus release maintains tibial internal rotation in CR TKA, resulting in achievement of postoperative high flexion angle.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Takayama
authors.affiliation: Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Muratsu
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Matsushita
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kuroda
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012399:Rotation; D013710:Tendons / Q000473:pathology; D013977:Tibia / Q000502:physiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: clinical outcome; flexion angle; medial release; semimembranosus tendon; tibial rotation; total knee arthroplasty