Shin Masuda1, Shinichi Miyazawa2, Kodama Yuya2, Yusuke Kamatski2, Hino Tomohito2, Okazaki Yoshiki2, Okazaki Yuki2, Takayuki Furumatsu2, Toshifumi Ozaki2. 1. Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan. me18066@s.okayama-u.ac.jp. 2. Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.
Abstract
PURPOSE: In total knee arthroplasty (TKA), it is important to obtain an appropriate flexion-extension gap. The extension gap is expanded by posteromedial vertical capsulotomy (PMVC). This study aimed to evaluate the increase in the extension gap by PMVC using a navigation system. METHODS: In posterior stabilized (PS)-type TKA, PMVC was performed in 37 knees. The medial extension gap at 0° and flexion gap at 90° flexion of the knee joint using the navigation system before and after PMVC were measured. RESULTS: The extension gap before the PMVC was 5.3 ± 2.9 mm. After PMVC, the extension gap had significantly increased to 8.0 ± 2.8 mm (p < 0.001). In addition, the flexion gap was 8.1 ± 2.7 mm before the PMVC, but it was 8.7 ± 2.8 mm after the PMVC, and the flexion gap was not enlarged (n.s.). CONCLUSION: In PS-type TKA, it is possible to obtain selective expansion of about 2.7 mm of the extension gap by PMVC. Therefore, gap balance can be acquired by soft-tissue treatment while preserving the bone. The PMVC was a useful method for acquiring gap balance and preserving the bone stock. LEVEL OF EVIDENCE: IV.
PURPOSE: In total knee arthroplasty (TKA), it is important to obtain an appropriate flexion-extension gap. The extension gap is expanded by posteromedial vertical capsulotomy (PMVC). This study aimed to evaluate the increase in the extension gap by PMVC using a navigation system. METHODS: In posterior stabilized (PS)-type TKA, PMVC was performed in 37 knees. The medial extension gap at 0° and flexion gap at 90° flexion of the knee joint using the navigation system before and after PMVC were measured. RESULTS: The extension gap before the PMVC was 5.3 ± 2.9 mm. After PMVC, the extension gap had significantly increased to 8.0 ± 2.8 mm (p < 0.001). In addition, the flexion gap was 8.1 ± 2.7 mm before the PMVC, but it was 8.7 ± 2.8 mm after the PMVC, and the flexion gap was not enlarged (n.s.). CONCLUSION: In PS-type TKA, it is possible to obtain selective expansion of about 2.7 mm of the extension gap by PMVC. Therefore, gap balance can be acquired by soft-tissue treatment while preserving the bone. The PMVC was a useful method for acquiring gap balance and preserving the bone stock. LEVEL OF EVIDENCE: IV.
Authors: Michael J McAuliffe; Patrick B O'Connor; Lisa J Major; Gautam Garg; Sarah L Whitehouse; Ross W Crawford Journal: J Knee Surg Date: 2019-02-08 Impact factor: 2.757
Authors: Thomas Luyckx; Hilde Vandenneucker; Lennart Scheys Ing; Evie Vereecke; Arnout Victor Ing; Jan Victor Journal: Clin Orthop Relat Res Date: 2018-03 Impact factor: 4.176
Authors: Willem A M van Lieshout; Kars P Valkering; Koen L M Koenraadt; Faridi S van Etten-Jamaludin; Gino M M J Kerkhoffs; Rutger C I van Geenen Journal: Knee Surg Sports Traumatol Arthrosc Date: 2018-08-14 Impact factor: 4.342