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

Michael J. McAuliffe; Patrick B. O'Connor; Lisa J. Major; Gautam Garg; Sarah L. Whitehouse; Ross W. Crawford

doi:10.1055/s-0039-1677873

The Journal of Knee Surgery, Table of Contents

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

¹Department of Orthopaedics, St. Andrews Private Hospital, Ipswich, Queensland, Australia

²School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia

,

Patrick B. O'Connor

³Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia

,

Lisa J. Major

⁴Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia

,

Gautam Garg

¹Department of Orthopaedics, St. Andrews Private Hospital, Ipswich, Queensland, Australia

²School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia

,

Sarah L. Whitehouse

²School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia

³Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia

,

Ross W. Crawford

²School of Biomedical Engineering, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, Queensland, Australia

³Department of Orthopaedics, The Prince Charles Hospital, Clinical Sciences Building, Queensland, Australia

› Author Affiliations

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

Full Text

References

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