Abstract
Improperly balanced total knee arthroplasties (TKA) increase risk of complications including instability and arthrofibrosis and frequently lead to revision procedures and decreased patient satisfaction. As traditional gap balancing or measured resection methods offer no quantitative measure of force or tension, several technological solutions have been proposed to improve appropriate balancing, including intraoperative sensors.
Smart tibial tray sensors assist surgeons during TKA by quantifying axial load distributions via medial and lateral compartment pressures through the range of motion. These wireless and disposable sensors are designed to integrate into the surgical flow of TKA; during the balancing portion of the procedure, they are substituted for standard polyethylene trials and provide a more consistent and reproducible methodology. As a result, quantitatively balanced knees demonstrate improved short-term outcomes compared to unbalanced knees. Balanced knees have shown improved Knee Society (KSS), Forgotten Joint (FJS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores, and additionally demonstrate decreased rates of revision procedures.
Ultimately, smart tibial trays are a useful technology that provides consistent and reproducible quantitative data in balancing the TKA in addition to improved short-term outcomes. However, as the device has only been clinically utilized since 2011, there remains a paucity of long-term data involving smart tibial trays. Future research should examine long-term implant survivorship and clinical outcomes.
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Krumme, J., Zhao, A., Golladay, G.J. (2023). Smart Tibial Trays. In: Deshmukh, A.J., Shabani, B.H., Waldstein, W., Oni, J.K. (eds) Surgical Management of Knee Arthritis. Springer, Cham. https://doi.org/10.1007/978-3-031-47929-8_9
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