title: A Targeted Approach to Ligament Balancing Using Kinetic Sensors.
abstract: Currently, soft-tissue imbalance contributes to several of the foremost reasons for revision following primary TKA, including instability, stiffness, and aseptic loosening. In order to decrease the incidence of soft-tissue imbalance, intraoperative sensors were developed to provide real-time, quantitative load data within the knee. This study examines the intraoperative data of a group of multicenter patients to determine how targeted ligament releases affect intra-articular loading, and to understand which types of releases are necessary to achieve quantified ligament balance.
  
  
  
  A group of 129 patients received sensor-assisted TKA, as part of a multicenter study. Medial and lateral loading data were collected pre-release, during any sequential releases, and post-release. All data were collected at 10°, 45°, and 90° during range of motion testing. Ligament release type, release technique type, and resultant loading were collected.
  
  
  
  Loading across the joint decreased, overall, and became more symmetrical after releases were performed. On average, between 2 and 3 corrections were made (up to 8) in order to achieve ligament balance. The ligament release type and subsequent quantified change in loading were in agreement with historical, qualified sources.
  
  
  
  Objective data from sensor output may assist surgeons in decreasing loading variability and, thereby, decreasing ligament imbalance and its associated complications.
authors.affiliation: Florida Orthopaedic Institute, Tampa, Florida.
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Gustke
authors.affiliation: Department of Orthopaedics, Virginia Commonwealth Medical Center, Richmond, Virginia.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Golladay
authors.affiliation: Department of Orthopaedics, Holy Cross Hospital, Fort Lauderdale, Florida.
authors.forename: Martin W
authors.initials: MW
authors.lastname: Roche
authors.affiliation: OrthoSensor Inc, Clinical Research, Dania Beach, Florida.
authors.forename: Leah C
authors.initials: LC
authors.lastname: Elson
authors.affiliation: OrthoSensor Inc, Clinical Research, Dania Beach, Florida.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Anderson
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007717:Knee / Q000601:surgery; D007719:Knee Joint / Q000502:physiology / Q000601:surgery*; D007720:Knee Prosthesis; D008022:Ligaments; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation; D016059:Range of Motion, Articular; D016474:Weight-Bearing
keywords: ligament balance; sensors; soft-tissue; surgical technique; total knee arthroplasty