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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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Central Sensitization is Associated with Persistent Postoperative Pain and Inferior Patient-Reported Outcomes in Patients Undergoing Unicompartmental Knee Arthroplasty ePoster Presentation Yong In, 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 Man-Soo Kim, MD, PhD, KOREA, REPUBLIC OF
Quality of Life Following Primary Total Knee Arthroplasty: Factors Predicting Satisfaction in Low-Income Population ePoster Presentation Mohamed Amine Gharbi , MD, TUNISIA Houssem Eddine Chahed, MD, TUNISIA Ahmed Zendeoui, MD, TUNISIA Moatassem Belleh Jelassi, MD, TUNISIA Anis Tebourbi, MD, TUNISIA Ramzi Bouzidi, PhD, TUNISIA Khelil Ezzaouia, PhD, TUNISIA Mouadh Nefiss, MD, TUNISIA
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
Influence of Mini Approach Instrumentation on Component Alignment In Unicondylar Knee Replacement ePoster Presentation Vinod Kumar, MBBS, MS, DNB, MNAMS, INDIA Deepak Gupta, MBBS, MS, INDIA Ananya Sharma, MBBS, MS, DNB , INDIA
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
Patient Satisfaction and Functional outcomes in a Latin American cohort: Comparative Study Between Conventional Technique vs. Robotic Arm Assistance. ePoster Presentation Rafael Calvo, MD, CHILE Maria Loreto Figueroa Berrios, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Zoy Anastasiadis, MD, CHILE David H. Figueroa, MD, CHILE
Effect of Direct Adductor Canal Block Performed by a Surgeon in a Patient Who Underwent Simultaneous Bilateral TKA 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
Impact of Femur Correction on the Mechanical Alignment of the Total Knee Prosthesis ePoster Presentation Israel Alejandro Alejandro González Rizo, MD, MEXICO Fidel G Dobarganes, Prof, MEXICO Jorge Negrete Corona, MD, MEXICO Alberto Guevara-Alvarez, MD, MEXICO Franco Garcini Munguia, MD, MEXICO
Short-Term Clinical Outcome Of Functionally Aligned Robotic-Assisted BCS TKA is Better Than That Of Mechanically Aligned Navigation-Assisted BCS TKA ePoster Presentation Daisuke Hamada, MD, PhD, JAPAN Keizo Wada, MD, JAPAN Yasuaki Tamaki, MD, JAPAN Yasuyuki Omichi, MD, JAPAN Tomohiro Goto, MD, PhD, JAPAN Koichi Sairyo, MD, PhD, JAPAN
Hip-Knee-Ankle Angle Affects Medial and Lateral Tibiofemoral Compressive Forces More Significantly than Joint Line Obliquity in Patients Post Total Knee Arthroplasty ePoster Presentation David A. Parker, MBBS, BMedSc, FRACS, AUSTRALIA Myles R. J. Coolican, FRACS, AUSTRALIA Brett A. Fritsch, MBBS BSc(Med), FRACS, FAOrthA, AUSTRALIA Alexander S. Nicholls, MSc, FRACS, AUSTRALIA Payam Tarassoli, MBChB, BSc, DipSEM, MD, FRCS, AUSTRALIA Yoong Lim, BEng, PhD, AUSTRALIA
Time-Driven Activity-Based Costs for Manipulation Under Anesthesia after Total Knee Arthroplasty ePoster Presentation Gloria Shoshana Coden, MD, UNITED STATES Suzanne Kent, MD, UNITED STATES John Mazzocco, MD, UNITED STATES Lauren Schoeller, BS, UNITED STATES Ruijia Niu, MPH, UNITED STATES Daniel C Sun, UNITED STATES Eric L. Smith, MD, UNITED STATES

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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