Matthew G Teeter1, Kevin I Perry2, Xunhua Yuan3, James L Howard4, Brent A Lanting4. 1. Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University and London Health Sciences Centre, London, ON, Canada; Department of Medical Biophysics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Surgical Innovation Program, Lawson Health Research Institute, London, ON, Canada; Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada. Electronic address: matthew.teeter@lhsc.on.ca. 2. Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University and London Health Sciences Centre, London, ON, Canada; Department of Orthopaedic Surgery, Mayo Clinic, Rochester, Minnesota. 3. Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada. 4. Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine & Dentistry, Western University and London Health Sciences Centre, London, ON, Canada.
Abstract
BACKGROUND:Measured resection (MR) and gap balancing (GB) are common surgical techniques for total knee arthroplasty (TKA). Controversy has arisen as each conceptually differs in how the knee is balanced through bone and soft tissue management. The objective of the present study was to compare both the frequency of condylar liftoff and the location of femorotibial contact from extension through midflexion between patients undergoing GB or MR TKA. METHODS: A total of 24 knees (23 patients) were randomly assigned at referral to either a surgeon performing MR or GB TKA with the same single radius, posterior-stabilized implant (12 per cohort). At 1-year postoperation, patients underwent biplanar radiographic imaging at 0°, 20°, 40°, and 60° of flexion. Condylar liftoff, contact location, and magnitude of excursion on each condyle were measured. Preoperative and postoperative clinical outcome scores were also collected. RESULTS: There was no difference (P = .41) in the frequency of liftoff between cohorts. The MR cohort had more posterior contact on the medial condyle (P < .01) and more anterior contact on the lateral condyle (P < .01) throughout flexion. Motion patterns were similar between cohorts, with similar medial (P = .48) and lateral (P = .44) excursion, which was equal in magnitude between condyles for both MR (P = .48) and GB (P = .73). There was no difference in clinical outcome scores between groups. CONCLUSION: For this particular implant system, GB and MR appear to produce similar kinematic and patient-reported outcome results.
RCT Entities:
BACKGROUND: Measured resection (MR) and gap balancing (GB) are common surgical techniques for total knee arthroplasty (TKA). Controversy has arisen as each conceptually differs in how the knee is balanced through bone and soft tissue management. The objective of the present study was to compare both the frequency of condylar liftoff and the location of femorotibial contact from extension through midflexion between patients undergoing GB or MR TKA. METHODS: A total of 24 knees (23 patients) were randomly assigned at referral to either a surgeon performing MR or GB TKA with the same single radius, posterior-stabilized implant (12 per cohort). At 1-year postoperation, patients underwent biplanar radiographic imaging at 0°, 20°, 40°, and 60° of flexion. Condylar liftoff, contact location, and magnitude of excursion on each condyle were measured. Preoperative and postoperative clinical outcome scores were also collected. RESULTS: There was no difference (P = .41) in the frequency of liftoff between cohorts. The MR cohort had more posterior contact on the medial condyle (P < .01) and more anterior contact on the lateral condyle (P < .01) throughout flexion. Motion patterns were similar between cohorts, with similar medial (P = .48) and lateral (P = .44) excursion, which was equal in magnitude between condyles for both MR (P = .48) and GB (P = .73). There was no difference in clinical outcome scores between groups. CONCLUSION: For this particular implant system, GB and MR appear to produce similar kinematic and patient-reported outcome results.
Authors: Paweł Skowronek; Markus Arnold; Christian Starke; Agnieszka Bartyzel; Lukas B Moser; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-04-30 Impact factor: 4.342
Authors: Matthew G Teeter; Jacob Wihlidal; Richard W McCalden; Xunhua Yuan; Steven J MacDonald; Brent A Lanting; Douglas D Naudie Journal: Clin Orthop Relat Res Date: 2019-01 Impact factor: 4.176
Authors: Harley A Williams; Jared Webster; Matthew G Teeter; James L Howard; Lyndsay E Somerville; Brent A Lanting Journal: Arthroplast Today Date: 2021-08-23
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