Does patella position influence ligament balancing in total knee arthroplasty?

Verfasser / Beitragende:
[Jung-Ro Yoon, Kwang-Jun Oh, Joon Wang, Jae-Hyuk Yang]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/7(2015-07-01), 2012-2018
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-2879-7  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2879-7 
245 0 0 |a Does patella position influence ligament balancing in total knee arthroplasty?  |h [Elektronische Daten]  |c [Jung-Ro Yoon, Kwang-Jun Oh, Joon Wang, Jae-Hyuk Yang] 
520 3 |a Purpose: In vivo comparative gap measurements were performed in three different patella positions (reduced, subluxated and everted) using offset-type-force-controlled-spreader-system. Methods: Prospectively, 50 knees were operated by total knee arthroplasty using a navigation-assisted gap-balancing technique. The offset-type-force-controlled-spreader-system was used for gap measurements. This commercially available instrument allows controllable tension in patella-reduced position. The mediolateral gaps of knee extension (0°) and flexion (90°) angle were recorded in three different patella positions; reduced, subluxated and everted. Any gap differences of more than 3mm were considered as a meaningful difference. Correlation between the difference with the demographic data, preoperative radiologic alignment and intraoperative data was analysed. For statistical analysis, ANOVA and Pearson's correlation test were used. Results: The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Statistically significant difference was observed for the lateral gap of patella eversion compared to gap of patella reduction in knee flexion position (p<0.05). There were notable cases of variability in knee flexion position. Significant portion of 12 (24%) knees of patella subluxation and 33 (66%) knees of patella evertion demonstrated either increased or decreased gaps in knee flexion position compared to the gaps of patella reduction position. Conclusion: The gaps in patella eversion demonstrated smaller gaps both in knee extension and flexion position compared to the gaps of patella reduction position. The amount of decreased gaps was more definite in knee flexion position. Therefore, the intraoperative patellar positioning has influence on the measurement of the joint gap. Keeping the patella in reduced position is important during gap balancing. Level of evidence: I. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Gap technique  |2 nationallicence 
690 7 |a Patella  |2 nationallicence 
690 7 |a Subluxated  |2 nationallicence 
690 7 |a Everted  |2 nationallicence 
690 7 |a Navigation  |2 nationallicence 
690 7 |a Total knee arthroplasty  |2 nationallicence 
700 1 |a Yoon  |D Jung-Ro  |u Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea  |4 aut 
700 1 |a Oh  |D Kwang-Jun  |u Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul, Republic of Korea  |4 aut 
700 1 |a Wang  |D Joon  |u Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea  |4 aut 
700 1 |a Yang  |D Jae-Hyuk  |u Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 2012-2018  |x 0942-2056  |q 23:7<2012  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2879-7  |q text/html  |z Onlinezugriff via DOI 
898 |a BK010053  |b XK010053  |c XK010000 
900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
908 |D 1  |a research-article  |2 jats 
949 |B NATIONALLICENCE  |F NATIONALLICENCE  |b NL-springer 
950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2879-7  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yoon  |D Jung-Ro  |u Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Oh  |D Kwang-Jun  |u Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul, Republic of Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Wang  |D Joon  |u Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Yang  |D Jae-Hyuk  |u Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 2012-2018  |x 0942-2056  |q 23:7<2012  |1 2015  |2 23  |o 167