Abstract
BackgroundIn total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance is measured after osteotomy of the distal femur and proximal tibia (conventional bone gap). However, after osteotomy, the flexion gap size during 90° knee flexion may be larger than that observed after implantation. The tension of the lateral compartment during 90° flexion may also be reduced after osteotomy of the distal femur. We manufactured a distal femoral trial component to reproduce the condition after implantation and prior to posterior condyle osteotomy. This study aimed to evaluate the effect of the trial component on the flexion gap.MethodsThis prospective study included 21 consecutive patients aged 78 years with medial osteoarthritis who underwent cruciate-retaining TKA between February 2017 and March 2018. The postoperative flexion gap size and inclination during 90° flexion were compared between cases with and without the trial component.ResultsThe mean joint gap size with the trial component (13.4 ± 0.80 mm) was significantly smaller than that without the trial component (14.7 ± 0.84 mm). The mean gap inclination angle with the trial component (3.7° ± 0.62°) was significantly smaller than that without the trial component (5.5° ± 0.78°).ConclusionsIn the present study, the joint gap size and medial tension were significantly reduced after the trial component had been set. Accurate measurement of the soft-tissue balance is an important factor in the modified gap technique, and this method using a distal femoral trial component can offer better outcomes than those achieved with conventional methods.
Highlights
In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance in extension and flexion is measured after osteotomy of the distal femur and proximal tibia, after which the rotation angle of the femur and the extent of bone resection from the posterior condyle are conventionally determined [1,2,3]
Accurate measurement of the soft-tissue balance is an important factor in the modified gap technique, and this method using a distal femoral trial component may yield better outcomes than those attained with conventional methods
In the present study, the joint gap size and medial tension were significantly reduced after the trial component had been set
Summary
In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance in extension and flexion is measured after osteotomy of the distal femur and proximal tibia, after which the rotation angle of the femur and the extent of bone resection from the posterior condyle are conventionally determined (conventional bone gap) [1,2,3].With the modified gap technique TKA, the basic concept is to achieve equal balance in both extension and 90°flexion. In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance in extension and flexion is measured after osteotomy of the distal femur and proximal tibia, after which the rotation angle of the femur and the extent of bone resection from the posterior condyle are conventionally determined (conventional bone gap) [1,2,3]. The tension of the lateral compartment during 90° flexion may be reduced after osteotomy of the distal femur (Fig. 1). In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance is measured after osteotomy of the distal femur and proximal tibia (conventional bone gap). The tension of the lateral compartment during 90° flexion may be reduced after osteotomy of the distal femur. This study aimed to evaluate the effect of the trial component on the flexion gap
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