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The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

Simon W. Young, MD, FRACS
NEW ZEALAND

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The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

Simon W. Young, MD, FRACS, NEW ZEALAND Matthew Carter, NEW ZEALAND Gavin William Clark, MBBS, FRACS, AUSTRALIA Christina Esposito, PhD, AUSTRALIA Matthew Walker, MBChB, FRACS, NEW ZEALAND

University of Auckland, Auckland, NEW ZEALAND

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Anatomic Location

Knee

Anatomic Structure

Cartilage Ligaments

Diagnosis / Condition

Arthritis

Treatment / Technique

Arthroplasty

Summary: A high percentage of TKAs can be balanced without soft tissue release using minor adjustments to component position, from both MA and KA start points.

Introduction

Ideal goals for alignment and balance in total knee arthroplasty (TKA) remain controversial. Some authors propose balance and alignment targets that more closely approximate the native knee. We aimed to compare initial alignment and gap balance using mechanical alignment (MA) and kinematic alignment (KA) techniques, and to analyze the percentage of knees that could achieve balance using limited adjustments to component position.

Methods

Prospective data on 388 primary robotic TKAs (154 MA and 234 KA) was analysed. Medial extension, lateral extension, medial flexion and lateral flexion virtual gaps were recorded. A computer algorithm calculated potential solutions to achieve soft tissue balance, utilizing virtual angular and translational adjustments of the tibial and femoral components (±1°, ±2°, or ±3° from initial). The percentage of knees that could achieve balance without soft tissue release was compared. We also analyzed the effect of balance targets with greater lateral gap tolerances (1-3mm).

Results

Less than 5% of TKAs were initially balanced in both KA and MA cohorts. Limited adjustments to component position increased the percentage of TKAs that could be balanced in a graduated manner, with no difference between MA and KA start points: adjustments of ±1° (10% vs 6% p=0.39), of ±2° (48% vs 38% p=0.23) or of ±3° (64% vs 51% p=0.39). A higher percentage of TKAs could be balanced when a greater tolerance for lateral gap laxity (up to 3mm) was allowed, in both KA and MA cohorts (KA 51% vs 88%, P< 0.01; MA 64% vs 89% p< 0.01).

Conclusion

A high percentage of TKAs can be balanced without soft tissue release using minor adjustments to component position, from both MA and KA start points. KA positioning alone did not lead to a more balanced knee. Surgeons should consider the relationship between alignment and balance goals when optimizing component positioning in TKA.

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Unicompartmental Knee Replacement and Femoropatellar Arthritis. 110 Ahroplasties with a Mean Follow p of 6 years. ePoster Presentation Stefano Gaggiotti, MD, ARGENTINA Santino Gaggiotti, MD, ARGENTINA Julio Cesar Ringa Gabriel Gaggiotti, MD, ARGENTINA
No Difference In Sports Participation And Patient-Reported Functional Outcomes Between Total Knee Arthroplasty And Unicompartmental Knee Arthroplasty At Minimum 2-Year Follow-Up In A Matched Control Study ePoster Presentation Amit Meena, MBBS, MS, DNB, INDIA Elisabeth Abermann, MD, AUSTRIA Christian Hoser, MD, AUSTRIA Luca Farinelli, MD, ITALY Caroline Hepperger, PhD, AUSTRIA Akshya Raj, MBBS,MS, INDIA Mohit Kumar Patralekh, MBBS, MS(Orthopaedics), DNB(Orthopaedics), MNAMS, INDIA Christian Fink, MD, Prof., AUSTRIA
Detection Loosening of Total Knee Arthroplasty Implant from Plain Radiograph Using Machine Learning Algorithm ePoster Presentation Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF Dongho Kwak, MD, KOREA, REPUBLIC OF Sungcheol Yang, MD, KOREA, REPUBLIC OF Hyukjin Jang, MD, KOREA, REPUBLIC OF Ryu Kyoung Cho, MD, KOREA, REPUBLIC OF Yong In, MD, PhD, KOREA, REPUBLIC OF
Follow-Up after Primary Total Knee Arthroplasty with the Sigma PFC implant (DePuy Synthes Inc.) in Patients with Metal Allergy or Hypersensitivity ePoster Presentation Natalie Mengis, MD, SWITZERLAND Jules-Nikolaus Rippke, Dr. med. (MD), SWITZERLAND Sebastian Schmidt, GERMANY Tudor Daniel Cucos, MD, GERMANY Luis Alfredo Navas Contreras, MD, GERMANY Daniel Krahl, MD, GERMANY Marcus Streit, Prof., GERMANY
Effect of Altered Knee Joint Loading Pattern in Gait Biomechanics of Total Knee Arthroplasty Patient ePoster Presentation Sang Jin Lee, MD, PhD, KOREA, REPUBLIC OF
Long-Term Results of Per-Operative Knee Arthroscopy in Confirming Suitability for Unicompartmental Arthroplasty ePoster Presentation James Gill, MB BChir, BSc, FRCS, UNITED KINGDOM McMeniman J Peter, AUSTRALIA Timothy John Mcmeniman, MBBS(Med)/MBBS, FRACS FA(Orth)A, AUSTRALIA Daniel Johnson Brimm, BSc, MD, AUSTRALIA Peter T. Myers, AM, MBBS, FRACS, FAOrthA, AUSTRALIA
Tibia Placement Difference Between The Supine And Prone Position After Total Knee Arthroplasty: The Comparison Of The BCS and PS-TKA ePoster Presentation Takanori Iriuchishima, MD, PhD, JAPAN Keinosuke Ryu, Prof., JAPAN Eiji Cho, MD, JAPAN
Association Between The Femoral And Tibial Component Positions and Intraoperative Knee Kinematics In Posterior-Stabilized Total Knee Arthroplasty ePoster Presentation Mitsuru Hanada, MD, PhD, JAPAN Yukihiro Matsuyama, MD, PhD, Prof., JAPAN
Does Robotic Assisted Unicompartmental Knee Arthroplasty Restore Native Jointline More Accurately Than With Conventional Instruments? ePoster Presentation Ashok Kumar Podhili Subramani, MS, INDIA Shantanu S. Patil, MBBS, MS(Orth), INDIA SAWAN PAWAR, MBBS MS (ORTH), INDIA Kalaivanan Kanniyan, MBBS MS Orth, INDIA karthik jayachandran, MS, INDIA PICHAI SURYANARAYAN, MBBS MS ORTH, INDIA
Changes In CPAK Classification and Its Characteristics before and after Kinematic Alignment TKA ePoster Presentation Manabu Akagawa, MD, PhD, JAPAN ヒデトモサイトウ, MD, PhD, JAPAN Naohisa Miyakoshi, MD, PhD, JAPAN
Is Surgeon Assessed Bone Quality During Total Knee Arthroplasty a Valid Tool To Diagnose Osteoporosis ? ePoster Presentation Adit Rajesh Maniar, MBBS, MS Orthopaedics, DNB Orthopaedics, INDIA Arpit Vasantbhai Bavaskar, MBBS, D.Orth., INDIA Vishal Raina, MS, INDIA Akshay Nayak, M.B.B.S, M.S , INDIA Ashwini Khokhar, MS, INDIA Rajesh Maniar, INDIA

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The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

Introduction

Methods

Results

Conclusion

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The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

The Effect of Minor Adjustments to Tibial and Femoral Component Position on Soft Tissue Balance in Robotic Total Knee Arthroplasty

Introduction

Methods

Results

Conclusion

More 2023 ISAKOS Congress Content