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The knee position at tourniquet inflation does not affect the gap balancing during total knee arthroplasty

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The relationship between gap balancing and clinical outcome of total knee arthroplasty (TKA) has been researched. Tourniquet is widely used by most surgeons; however, there are little quantitative data about the gap depending on the tourniquet usage. We aimed to investigate whether the knee position at tourniquet inflation affected the gap measurement intra-operatively.

Methods

TKA was performed for 104 knees and the tourniquet was inflated with the knee at full flexion and extension. The gap was measured in each static knee flexion status (0°, 30°, 45°, 60°, 90°, 120°, and in full flexion) using a tensor. We measured the gap twice; under the tourniquet inflation and release. The gap difference at each static knee flexion status was calculated by subtracting the gap under release from that under inflation.

Results

When the tourniquet was inflated with the knee at full flexion, the mean gap differences were < 1 mm and < 1° in each static knee flexion status. When the tourniquet was inflated with the knee at full extension, the mean gap differences were < 1 mm and < 1°, respectively. All values of the gap difference were minimum, and were not affected by the tourniquet, whether the knee position at the tourniquet inflation was flexed or extended.

Conclusions

We postulated that the knee position at tourniquet inflation would affect the gap, which was refuted by our results. This shows that we can measure the gap without considering the knee position at tourniquet inflation.

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Authors and Affiliations

  1. Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima, Osaka, Osaka, 534-0021, Japan

    Yoshio Matsui, Masanori Matsuura & Noriaki Hidaka

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  1. Yoshio Matsui
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  2. Masanori Matsuura
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  3. Noriaki Hidaka
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by YM, MM, and NH. The first draft of the manuscript was written by YM and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yoshio Matsui.

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All authors have no financial or proprietary interests in any material discussed in this article.

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The study design was approved by the institutional review board and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Matsui, Y., Matsuura, M. & Hidaka, N. The knee position at tourniquet inflation does not affect the gap balancing during total knee arthroplasty. Arch Orthop Trauma Surg 142, 1653–1659 (2022). https://doi.org/10.1007/s00402-021-04017-5

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  • DOI: https://doi.org/10.1007/s00402-021-04017-5

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