Abstract
Joint gap balancing during total knee arthroplasty has been an empirical undertaking to date. Ligament tensioning devices exist to aid soft tissue management, however quantifying tension remains problematic. The purpose of this study was to validate modifications made to a current balancing system, allowing for quantification of joint load using a computer-assisted technique. An additional goal was to determine if the tool would improve joint gap management and consequently load balance in an in-vitro model. The load sensing capability of the tool was validated under known loading conditions. Intra-operative use of the tool relative to current techniques was evaluated in a preliminary in-vitro study using cadaveric knees. There was a trend towards improved joint gap management when using the tensioning device, but this did not translate into a more balanced joint in our knee simulator.
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Griffin, F.M., Insall, J.N., Scuderi, G.R.: Accuracy of soft tissue balancing in total knee arthroplasty. J. Arthroplasty 15, 970–973 (2000)
Krackow, K.A., Mihalko, W.M.: The effect of medial release on flexion and extension gaps in cadaveric knees: implications for soft-tissue balancing in total knee arthroplasty. Am. J. Knee. Surg. 12, 222–228 (1999)
Krackow, K.A., Mihalko, W.M.: Flexion-extension joint gap changes after lateral structure release for valgus deformity correction in total knee arthroplasty: a cadaveric study. J. Arthroplasty 14, 994–1004 (1999)
Mihalko, W.M., Miller, C., Krackow, K.A.: Total knee arthroplasty ligament balancing and gap kinematics with posterior cruciate ligament retention and sacrifice. Am. J. Orthop. 29, 610–616 (2000)
Attfield, S.F., Warren-Forward, M., Wilton, T., Sambatakakis, A.: Measurement of soft tissue imbalance in total knee arthroplasty using electronic instrumentation. Med. Eng. Phys. 16, 501–505 (1994)
Sambatakakis, A., Attfield, S.F., Newton, G.: Quantification of soft-tissue imbalance in condylar knee arthroplasty. J. Biomed. Eng. 15, 339–343 (1993)
Attfield, S.F., Wilton, T.J., Pratt, D.J., Sambatakakis, A.: Soft-tissue balance and recovery of proprioception after total knee replacement. J. Bone Joint Surg. Br 78, 540–545 (1996)
Winemaker, M.J.: Perfect balance in total knee arthroplasty: the elusive compromise. J. Arthroplasty 17, 2–10 (2002)
El-Hawary, R., Roth, S.E., Harwood, C., Johnson, J.A., King, G.J., Chess, D.G.: The Effect of the Posterior Cruciate Ligament on Total Knee Arthroplasty Load Balance. In: 49th Annual Meeting, Orthopaedic Research Society 2003 (2003)
Li, G., Rudy, T.W., Sakane, M., Kanamori, A., Ma, C.B., Woo, S.L.: The importance of quadriceps and hamstring muscle loading on knee kinematics and in-situ forces in the ACL. J. Biomech. 32, 395–400 (1999)
Roth, S.E., Chess, D.G., Dunning, C., Johnson, J.A., King, G.J.: Design of a Transducer to Measure Intra-Operative Loading During Total Knee Replacement. In: 35th Annual Meeting, Canadian Orthopedic Research Society 2001 (2001)
Kunz, M., Strauss, M., Langlotz, F., Deuretzbacher, G., Ruther, W., Nolte, L.-P.: A non-CT based total knee arthroplasty system featuring complete soft-tissue balancing. In: Niessen, W.J., Viergever, M.A. (eds.) MICCAI 2001. LNCS, vol. 2208, p. 409. Springer, Heidelberg (2001)
Stiehl, J.B., Cherveny, P.M.: Femoral rotational alignment using the tibial shaft axis in total knee arthroplasty. Clin. Orthop. 47–55 (1996)
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Skrinskas, T.V., Viskontas, D.G., Ferreira, L., Chess, D.G., Johnson, J.A. (2003). Application of an Intra-operative Load Measuring System for Knee Replacement Surgery. In: Ellis, R.E., Peters, T.M. (eds) Medical Image Computing and Computer-Assisted Intervention - MICCAI 2003. MICCAI 2003. Lecture Notes in Computer Science, vol 2878. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-39899-8_31
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DOI: https://doi.org/10.1007/978-3-540-39899-8_31
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