caa a22 4500 605457131 CHVBK 20210128100221.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00167-014-2879-7 doi (NATIONALLICENCE)springer-10.1007/s00167-014-2879-7 Does patella position influence ligament balancing in total knee arthroplasty? [Elektronische Daten] [Jung-Ro Yoon, Kwang-Jun Oh, Joon Wang, Jae-Hyuk Yang] 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. Springer-Verlag Berlin Heidelberg, 2014 Gap technique nationallicence Patella nationallicence Subluxated nationallicence Everted nationallicence Navigation nationallicence Total knee arthroplasty nationallicence Yoon Jung-Ro Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea aut Oh Kwang-Jun Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul, Republic of Korea aut Wang Joon Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea aut Yang Jae-Hyuk Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 2012-2018 0942-2056 23:7<2012 2015 23 167 https://doi.org/10.1007/s00167-014-2879-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-2879-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yoon Jung-Ro Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Oh Kwang-Jun Department of Orthopaedic Surgery, School of Medicine, Konkuk University, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Wang Joon Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Yang Jae-Hyuk Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 6-2 Dunchon Dong, Kangdong Ku, Seoul, Republic of Korea aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/7(2015-07-01), 2012-2018 0942-2056 23:7<2012 2015 23 167