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J Knee Surg 2020; 33(03): 247-254
DOI: 10.1055/s-0039-1677873
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Highly Satisfied Total Knee Arthroplasty Patients Display a Wide Range of Soft Tissue Balance

Michael J. McAuliffe 
1   Department of Orthopaedics, St. Andrews Private Hospital, Ipswich, Queensland, Australia
2   School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia
,
Patrick B. O'Connor
3   Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia
,
Lisa J. Major
4   Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
,
Gautam Garg
1   Department of Orthopaedics, St. Andrews Private Hospital, Ipswich, Queensland, Australia
2   School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia
,
Sarah L. Whitehouse
2   School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia
3   Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia
,
Ross W. Crawford
2   School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia
3   Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia
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Publikationsverlauf

06. September 2018

16. Dezember 2018

Publikationsdatum:
08. Februar 2019 (online)

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Abstract

Soft tissue balancing while crucial for a successful total knee arthroplasty (TKA) is incompletely defined and the subject of broad recommendations. We analyzed 69 unilateral computer-assisted surgery posterior stabilized (PS) TKA subjects who postoperatively scored ≥36 out of a possible 40 points on the satisfaction section of the American Knee Society score (2011). We examined a range of postoperative coronal plane laxity parameters and the correlation between preoperative and postoperative laxity. Total postoperative coronal laxity arcs at maximum extension and 20 degrees of flexion varied between 2 and 12 and 3 and 13 degrees, respectively. Depending on the position of measurement, medial laxity was between 0.5 and 9.5 degrees and lateral laxity between 1 and 12 degrees. The change in laxity between maximum extension and 90 degrees of flexion demonstrated a range of 7 degrees medially and 12 degrees laterally. The total coronal arc of movement did not affect functional outcomes. A moderate correlation of 0.452 and 0.424 was seen between initial and postoperative total coronal laxity arcs in maximum extension and 20 degrees of flexion, respectively. The individual variability for each measured parameter within our cohort demonstrates TKA satisfaction is not as simple as producing a narrow range of coronal laxity parameters and that as with many body systems considerable variation is still consistent with excellent function. Our findings help to define acceptable balance parameters for PS TKA. It does not appear necessary to closely match postoperative laxity to that present preoperatively.

Keywords

total knee arthroplasty - ligament balance - posterior stabilized - highly satisfied