Automated hydraulic tensor for Total Knee Arthroplasty.

To obtain a long lifespan of knee prosthesis, it is necessary to restore the alignment of the lower limb. In some cases of severe arthrosis, the ligament envelope of the joint may be deformed, inducing an asymmetric laxity once the lower limb is realigned. Because there is not yet unanimity regarding how to optimally measure or implement soft tissue balance, we provide a means to acquire a variety of measurements. In traditional surgery, the surgeon sometimes uses a "tensor", which acts like a forceps. This system was redesigned, instrumented, actuated, and integrated into a navigation system for orthopaedic surgery. Improving the perception of the surgeon, it helps him to address the ligament balancing problem. Our first prototype has been tested on sawbones before being validated in an experiment on two cadavers. In our first attempt, the surgeon was able to assess soft tissue balance but judged the device not powerful enough, which led us to develop a new more powerful hydraulic system. In this paper, we present our approach and the first results of the new hydraulic tensor which is currently in an integration process. Copyright 2005 John Wiley & Sons, Ltd.