Abstract
Instruction
Total knee arthroplasty (TKA) performed with the gap technique can achieve rectangular gaps during flexion and extension by proper bone resection and subsequent soft tissue release. Acquisition of appropriate soft tissue balance is important for successful TKA. It is unknown, however, whether the intraoperative well-balanced ligamentous laxity changes postoperatively over time. We hypothesized that even if good soft tissue balance was achieved intraoperatively the lateral ligamentous laxity would increase with time postoperatively. This phenomenon depends on preoperative background factors.
Methods
We used the angle between the component surfaces of the tibia and femur to define ligamentous laxity. Changes in ligamentous laxity after posterior stabilized minimally invasive surgery (MIS)-TKA were analyzed retrospectively in 150 knees based on radiographic measurements. At 12 months after the operation, the cases were divided into two groups in which the lateral ligamentous laxity in flexion was either ≤3° (balanced group) or >3° (unbalanced group). Factors with a potential to encourage postoperative ligamentous laxity were analyzed.
Results
Our data show that the postoperative ligamentous laxity in extension did not change, whereas the lateral ligamentous laxity in flexion increased with time. This change was significantly related to the preoperative lateral ligamentous laxity, body weight, body mass index, and age.
Conclusion
The results of this study should be taken into account by surgeons performing MIS-TKA with the gap technique.
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Hayashi, S., Murakami, Y., Inoue, H. et al. Changes in ligamentous laxity after posterior stabilized total knee replacement and factors correlated with postoperative laxity. Eur Orthop Traumatol 5, 267–272 (2014). https://doi.org/10.1007/s12570-013-0239-6
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DOI: https://doi.org/10.1007/s12570-013-0239-6