Stiffness of soft tissue complex in total knee arthroplasty

  • Hiroshi AsanoEmail author
  • Takeshi Muneta
  • Akiho Hoshino


The significance of achievement of soft tissue balancing in total knee arthroplasty is well recognized. There are few reports dealing with soft tissue tension in total knee arthroplasty. It is expected that the soft tissue tension will affect post-operative results such as postoperative ROM and stability. The purpose of this study was to evaluate tension properties of soft tissue complex of osteoarthritic knee in total knee arthroplasty. Sixty osteoarthritic knees that underwent primary total knee arthroplasty were investigated with a balancer and torque driver specially developed and adapted for this study. We gradually opened the extension and flexion space and measured the force to open it. We created a force–displacement curve in each case. Inclination of the curve indicated stiffness. We examined the stiffness average of all cases every 10 N. The stiffness was 8.9 and 8.5 N/mm (extension, flexion) in soft tissue tension of 60 N and 26.6 and 21.4 N/mm in 180 N. The stiffness became larger with an increase of soft tissue tension, and the stiffness of extension is significantly larger than that of flexion in each tension except for 60 N. Tension properties of soft tissue complex reveal that soft tissue can be easily extended in low soft tissue tension, and hardly extended in high tension.


Stiffness Arthroplasty Knee Soft tissue Tension 


  1. 1.
    Asano H, Hoshino A, Wilton TJ (2004) Soft tissue tension in total knee arthroplasty. Arthroplasty 19(5):632–634CrossRefGoogle Scholar
  2. 2.
    Attfield SF, Warren-Forward M, Wilton TJ, Sambatakakis A (1994) Measurement of soft tissue imbalance in total knee arthroplasty using electronic instrumentation. Med Eng Phys 16:501–504PubMedCrossRefGoogle Scholar
  3. 3.
    Griffin FM, Insall JN, Scuderi GR (2000) Accuracy of soft tissue balancing in total knee arthroplasty. Arthroplasty 15(8):970–973CrossRefGoogle Scholar
  4. 4.
    Laskin RS, Rieger MA (1989) The surgical technique for performing a total knee replacement arthroplasty. Orthop Clin North Am 20:31–48PubMedGoogle Scholar
  5. 5.
    Takahashi T, Wada Y, Yamamoto H (1997) Soft-tissue balancing with pressure distribution during total knee arthroplasty. J Bone Joint Surg 79-B:235–239CrossRefGoogle Scholar
  6. 6.
    Noyes FR, Grood FS (1976) The strength of the anterior cruciate ligament in humans and rhesus monkeys. Age related and species-related changes. J Bone Joint Surg 58-A:583–593Google Scholar
  7. 7.
    Sambatakakis A, Wilton TJ, Newton G (1991) Radiographic sign of persistent soft-tissue imbalance after knee replacement. J Bone Joint Surg 73-B:751–756Google Scholar
  8. 8.
    Trent PS, Walker PS, Wolf B (1976) Ligament length patterns, strength, and rotational axes of the knee joint. Clin Orthop 117:263–270PubMedGoogle Scholar
  9. 9.
    Woo SLY, Hollis M, Adams DJ et al (1991) Tensile properties of the human femur-anterior cruciate ligament-tibia complex. The effects of specimen age and orientation. Am J Sports Med 19: 217–225PubMedCrossRefGoogle Scholar
  10. 10.
    Yagishita K, Muneta T, Ikeda H (2003) Step-by-step measurement of soft tissue balancing during total knee arthroplasty for patients with varus knees. Arthroplasty 18:313–320CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.Minato Redcross HospitalYokohamaJapan
  2. 2.Tokyo Medical and Dental UniversityTokyoJapan
  3. 3.Kawaguchi Kohgyo General HospitalKawaguchiJapan
  4. 4.TokyoJapan

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