Abstract
PurposeTo evaluate the influence of thigh weight in different hip flexion positions on the knee flexion gap in total knee arthroplasty (TKA).Materials and MethodsWe evaluated 20 patients (25 knees) with osteoarthritis of the knee that underwent TKA using a navigation system from May 2010 to April 2011. After posterior cruciate ligament sacrificing, complete soft tissue balancing, and fixation of all components with cement, the flexion gaps were measured with the patello-femoral joint reduced. Medial and lateral flexion gaps were measured separately in both the 90°-90° and 45°-90° flexion positions of the hip-knee joints.ResultsThe medial and lateral flexion gaps in the 45°-90° flexion position of the hip-knee joints were 13.02±2.17 mm and 13.12±2.21 mm, respectively. The medial and lateral flexion gaps in the 90°-90° flexion position were 12.92±2.03 mm and 13.08±2.29 mm, respectively. The flexion gaps showed no significant (p>0.05) differences between the two different hip flexion positions.ConclusionsFlexion gaps in TKA were not influenced by hip flexion positions (45° or 90° of flexion). Therefore, soft tissue balancing and polyethylene thickness should not be affected by hip flexion positions during TKA.
Highlights
An essential principle in total knee arthroplasty (TKA) is soft tissue balance that is obtained by symmetrical medial and lateral flexion-extension gaps in the coronal plane[1,2,3])
The purpose of this study was to investigate the impact of different hip-knee flexion positions (45o−90o vs. 90o−90o) on the flexion gap of the knee in TKA using a navigation system for measurements
Our hypothesis was that the flexion gap would be significantly reduced when the hip is in 45o of flexion due to the thigh weight
Summary
An essential principle in total knee arthroplasty (TKA) is soft tissue balance that is obtained by symmetrical medial and lateral flexion-extension gaps in the coronal plane[1,2,3]). It has been traditionally perceived that the extension gap of the knee should be assessed with both the hip and knee in neutral. There is room for controversy regarding the optimal hip flexion position for accurate measurement of the flexion gap of the knee. This is because tension of the adjacent soft tissues, including the iliotibial band and the quadriceps muscle, deemed affected by the hip flexion position and the weight of the thigh may have an influence on the knee joint space. Our hypothesis was that the flexion gap would be significantly reduced when the hip is in 45o of flexion due to the thigh weight
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
