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Improved Mediolateral Gap Balance Achievement with Instrumented Navigated Total Knee Arthroplasty Compared to Conventional Instrumentation

5 pagesPublished: December 13, 2022

Abstract

Total knee replacement (TKA) represents a well-established reconstructive procedure for end-stage knee joint disorders with the balancing of soft-tissue envelope throughout the full arc of motion as a newly emerging possibility. This cadaveric study evaluated the ability to achieve targeted mediolateral (ML) gap balance throughout the arc of motion using conventional mechanical instrumentation versus a computer-assisted orthopaedic surgery (CAOS) system featuring an intraarticular distractor while considering surgeon experience level. For the CAOS system, an intraarticular distractor applied a quasi- constant distraction force to the joint (instrumented) while the conventional system involved conventional spacers. Regardless of experience level, the instrumented TKAs were associated with a significantly lower ML gap differential than the conventional TKAs. In contrast, regardless of the type of instrumentation, there were no significant differences between the junior and senior surgeon mean gaps. Historically, soft tissue balancing during TKA has been reported as an art rather than a science. In this regard, the addition of dedicated technology to characterize the soft-tissue envelope during TKA has the potential to provide an augmented perspective to the surgeon and can be particularly beneficial for junior surgeons. The present study established that the usage of instrumented CAOS led to significantly lower ML gap differences than conventional instrumentation.

Keyphrases: experience, force controlled distractor, ligament laxity, soft tissue balance, total knee arthroplasty

In: Ferdinando Rodriguez Y Baena, Joshua W Giles and Eric Stindel (editors). Proceedings of The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 5, pages 5-9.

BibTeX entry
@inproceedings{CAOS2022:Improved_Mediolateral_Gap_Balance,
  author    = {Laurent Angibaud and Wen Fan and Florian Kerveillant and Philippe Dubard and Marine Torrollion and Matthew Rueff and Alexander Sah and James Huddleston},
  title     = {Improved Mediolateral Gap Balance Achievement with Instrumented Navigated Total Knee Arthroplasty Compared to Conventional Instrumentation},
  booktitle = {Proceedings of The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Ferdinando Rodriguez Y Baena and Joshua W Giles and Eric Stindel},
  series    = {EPiC Series in Health Sciences},
  volume    = {5},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/SNP8},
  doi       = {10.29007/4lwm},
  pages     = {5-9},
  year      = {2022}}
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