TITLE

The influence of patellar position on soft tissue balance in minimal incision total knee arthroplasty

AUTHOR(S)
Oka, Shinya; Muratsu, Hirotsugu; Matsumoto, Tomoyuki; Kubo, Seiji; Maruo, Akihiro; Miya, Hidetoshi; Kuroda, Ryosuke; Kurosaka, Masahiro
PUB. DATE
June 2012
SOURCE
Knee Surgery, Sports Traumatology, Arthroscopy;Jun2012, Vol. 20 Issue 6, p1064
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose: This study aims to clarify the influence of surgical exposure on intra-operative soft tissue balance measurements using a new tensor in minimal incision total knee arthroplasty (TKA). Methods: Sixty patients with osteoarthritis of the knee received minimal incision TKAs. Twenty patients received a posterior-stabilized TKA using a quadriceps sparing approach, and the other forty patients, using a limited medial parapatellar (mini) approach. After femoral trial placement, soft tissue balance was measured using an offset type tensor at full extension and 90° of knee flexion, with the patella both laterally retracted and reduced. The joint component gap and varus imbalance were used to assess the difference in patellar position and surgical exposure. Results: At extension, the joint component gap and varus imbalance showed no statistical difference regardless of patellar position in either TKA. However, the joint component gaps decreased at 90° of flexion when the patella was laterally retracted in both TKAs. Additionally, a significantly smaller joint gap was observed in the quadriceps sparing TKA than the mini-TKA with a retracted patella at 90° of flexion. Varus ligament imbalances decreased with the patella laterally retracted at 90° of flexion in the quadriceps sparing TKA, not in the mini-TKA. Conclusion: Surgeons should be aware of the influence in surgical exposure of the joint gap and ligament balance during patella shift in minimal incision TKA. Level of evidence: III.
ACCESSION #
75346031

 

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