Title :

Variation in knee balance as a function of hip-knee-ankle angle and joint line obliquity in robotic assisted total knee arthroplasty.

Author(s) :

Kim, Raymond [Auteur]
Wakelin, Edgard A. [Auteur]
Plaskos, Christopher [Auteur]
Gupta, Sanjeev [Auteur]
Putman, Sophie [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Journal title :

International Orthopaedics

Abbreviated title :

Int Orthop

Volume number :

47

Pages :

479–484

Publication date :

2022-12-01

ISSN :

1432-5195

English keyword(s) :

Robotic-assisted total knee arthroplasty
Coronal plane alignment of the knee
CPAK
Balance
TKA
Robotics

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Purpose To describe the mediolateral (ML) gap balance in pre-resection arthritic knees undergoing robot-assisted (RA) total knee arthroplasty (TKA) within the nine phenotypes of the Coronal Plane Alignment of the Knee ...
Show more >Purpose To describe the mediolateral (ML) gap balance in pre-resection arthritic knees undergoing robot-assisted (RA) total knee arthroplasty (TKA) within the nine phenotypes of the Coronal Plane Alignment of the Knee (CPAK) classification. Methods A total of 1124 RA TKA cases were retrospectively reviewed. ML balance was calculated using a digital ligament tensioning device following tibial resection and prior to any femoral resection throughout flexion (10°, 40°, and 90°). Lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) were landmarked intra-operatively and adjusted for wear based on hip-knee-ankle angle (HKA). Knees were then subdivided into CPAK categories based on the arithmetic HKA (aHKA) and joint line obliquity (JLO). Differences in balance between CPAK phenotypes were compared. Results For aHKA, a greater medial gap was observed in varus compared to neutral or valgus knees at 10° (5.2 ± 3.0 mm vs 3.3 ± 3.2 mm vs − 0.4 ± 5.0 mm respectively; p < 0.0001). A similar trend was observed for JLO in distal apex compared to neutral and proximal apex knees at 10° (3.4 ± 3.6 vs 1.1 ± 5.0 vs − 2.4 ± 6.3 respectively; p < 0.0001). The greatest ML balance differences were found when combining JLO and aHKA at 10° (type I vs type VI: ∆6.6 mm; p < 0.0001). Conclusion There is a high degree of variability in arthritic ML balance within and between each CPAK phenotype. A single alignment philosophy based on bony landmarks alone may not be sufficient to balance all knees. Utilisation of robotics and digital ligament tensioning devices serves as important adjuncts to characterize the patient-specific soft tissue profile.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
CHU Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2023-11-15T03:00:49Z
2024-04-22T11:03:41Z