Gap balancing improve squat function and knee function: a randomized controlled trial comparing gap balancing and measured resection

Qingfang Xiao,Bo Liu,Binghao Zhao

doi:10.1186/s13018-021-02367-9

Qingfang Xiao, Bo Liu + Show 1 more

Open Access

https://doi.org/10.1186/s13018-021-02367-9

Copy DOI

Abstract

ObjectiveWe compared the measured resection (MR) technique and the gap balancing (GB) technique in patients with knee osteoarthritis after primary total knee arthroplasty (TKA) in China to understand the effects of the two techniques on knee function and squat function.MethodsFrom March 2017 to September 2019, a prospective randomized controlled trial was conducted with 96 patients with knee osteoarthritis undergoing primary TKA from March 2017 to September 2019 randomized to GB group (n = 48) and MR group (n = 48). Intraoperative indicators (operation time, osteotomy volume of medial and lateral of posterior femoral condyles, external rotation angle) were recorded during operation. At 1, 3, 6, and 12 months after surgery, all the patients came to the hospital for review and underwent the pain severity, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), knee joint range of motion, Oxford Knee Score (OKS), and American Knee Society Score (AKSS) tests. All patients were followed up for more than 1 year.ResultsThe osteotomy volume of the medial femoral condyle in the GB group was higher than that in the MR group (P<0.05), and the operation time in the GB group was shorter than that in the MR group (P<0.05). At 1, 3, 6, and 12 months after surgery, the pain severity in the GB group was lower than that in the MR group (P<0.05), the knee range of motion in the GB group was larger than that in the MR group (P<0.05), the WOMAC of the GB group was lower than that of the MR group (P<0.05), the OKS of the GB group was higher than that of the MR group (P<0.05), the AKSS of the GB group was higher than that of the MR group. The incidence of postoperative complications in the GB group (4.17%) was significantly lower than that in the MR group (18.75%) (P<0.05).ConclusionThe GB technique can effectively shorten the operation time, relieve pain, improve knee range of motion, improve squat function and knee function, reduce osteoarthritis index, and reduce the occurrence of complications, which is worthy of clinical popularization and application.

Highlights

In recent years, with the increasing aging of population and obesity, the incidence of knee osteoarthritis has been increasing year by year [1]
There were no significant differences in the osteotomy volume of the lateral posterior femoral condyle and external rotation angle between the two groups (P > 0.05) (Table 2)
We found that both techniques could significantly improve knee function and Operation time Osteotomy volume of medial posterior femoral condyle Osteotomy volume of lateral Posterior femoral condyle external rotation angle (°)

Summary

Introduction

With the increasing aging of population and obesity, the incidence of knee osteoarthritis has been increasing year by year [1]. Among patients with knee osteoarthritis who received surgical treatment, total knee arthroplasty (TKA) yields high satisfaction and has been strongly recommended by the American Academy of Orthopaedics as a means of treatment for end-stage knee osteoarthritis [2, 3]. It can effectively alleviate the degree of knee deformity, provide pain relief, restore knee joint function, and help patients maintain an independent lifestyle. There are two different methods to achieve a balanced knee in TKA: measured resection (MR) technique and the gap balancing (GB) technique, or balanced resection [4]. The GB technique tends to elevate the joint line, which may affect the postoperative effect and safety [9]

Methods

Results

Conclusion