Background: The optimal "target" ligament balance for each patient undergoing total knee arthroplasty (TKA) remains unknown. The study purpose was to determine if patient outcomes are affected by intraoperative ligament balance measured with force-sensing implant trials and if an optimal "target" balance exists.
Methods: A multicenter, retrospective study reviewed consecutive TKAs performed by 3 surgeons. TKA's were performed with standard surgical techniques and ligament releases. After final implants were made, sensor-embedded smart tibial trials were inserted, and compartment forces recorded throughout the range of motion. Clinical outcome measures were obtained preoperatively and at 4 months. Statistical analysis correlated ligament balance with clinical outcomes.
Results: One hundred eighty-nine consecutive TKAs were analyzed. Patients were grouped by average medial and lateral compartment force differences. Twenty-nine TKAs (15%) were balanced within 15 lbs and 53 (28%) were "balanced" greater than 75 lbs. Greater improvement in University of California Los Angeles activity level was associated with a mediolateral force difference <60 lbs. (P = .006). Knee Society objective, function, and satisfaction scores, and self-reported health state were unrelated to mediolateral balance in the knee.
Conclusion: Intraoperative force-sensing has potential in providing real-time objective data to optimize TKA outcomes. These data support some early outcomes may improve by balancing TKAs within 60 lbs difference. Close follow-up is warranted to determine if gait pattern adaptations affect longer term outcomes with greater or less ligament "imbalance."
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http://dx.doi.org/10.1016/j.arth.2016.03.046 | DOI Listing |
Pharmaceutics
January 2025
Department of Pharmacology, School of Medicine, University of Mostar, 88000 Mostar, Bosnia and Herzegovina.
Background: This is a novel rat study using native peptide therapy, focused on reversing quadriceps muscle-to-bone detachment to reattachment and stable gastric pentadecapeptide BPC 157 per-oral therapy for shared muscle healing and function restoration.
Methods: Pharmacotherapy recovering various muscle, tendon, ligament, and bone lesions, and severed junctions (i.e.
Medicina (Kaunas)
January 2025
Hospital Virgen de la Concha, 49022 Zamora, Spain.
: Up to 27% of anterior cruciate ligament (ACL) reconstruction cases result in a residual positive pivot shift sign, indicating anteroposterior and rotational instability. This instability can compromise returning to sports and increase the risk of further injuries. The biomechanical role of the anterolateral ligament (ALL) in controlling internal knee rotation is well known.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, University Hospital centre (Saint Etienne), Avenue Albert Raimond, Saint-priest-en-Jarez, 42270, France.
Introduction: Total knee arthroplasty (TKA) in valgus knees is challenging. Optimal ligament balance, implant neutral or moderate valgus alignment are crucial but conventional instrumentations usually lead to outliers. Robotic arm assisted TKA (RATKA) advantages could answer this challenge.
View Article and Find Full Text PDFOrthop Surg
January 2025
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, China.
Objective: Robotic-assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic-assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic-assisted TKA.
View Article and Find Full Text PDFAm J Sports Med
January 2025
The Steadman Clinic, Vail, Colorado, USA.
Background: There is growing evidence that medial meniscotibial ligament (MTL) deficiency and medial meniscus extrusion may precede the development of some medial meniscus posterior root (MMPR) tears. However, no study has investigated the biomechanical consequences of MTL deficiency on the MMPR.
Hypothesis: (1) MTL deficiency leads to increased medial meniscus extrusion, (2) increased medial meniscus extrusion is correlated with increased compression and shear forces at the MMPR, and (3) MTL repair restores medial meniscus extrusion and MMPR forces to native levels.
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