scholarly journals Rotational Soft-Tissue Balance Is Highly Correlated with Rotational Kinematics in Total Knee Arthroplasty

2021 ◽  
Author(s):  
Tomofumi Kinoshita ◽  
Kazunori Hino ◽  
Tatsuhiko Kutsuna ◽  
Kunihiko Watamori ◽  
Hiromasa Miura
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Knee Kinematics ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Rotational Kinematics ◽  
Total Knee

AbstractRecovery of normal knee kinematics is critical for improving functional outcomes and patient satisfaction after total knee arthroplasty (TKA). The kinematics pattern after TKA varies from case to case, and it remains unclear how to reproduce normal knee kinematics. The present study aimed to evaluate rotational knee kinematics and soft-tissue balance using a navigation system and to assess the influence of intraoperative soft-tissue balance on the rotational knee kinematics. We evaluated 81 osteoarthritic knees treated with TKA using a posterior stabilized (50 knees) or cruciate retaining (31 knees) prosthesis. Rotational kinematics were assessed at 0, 30, 45, 60, and 90 degrees flexion angles by using a computer-assisted navigation system. Correlation between femorotibial rotational position and measured soft tissue balance was assessed by using Spearman's rank correlation coefficient. Rotational soft-tissue balance (the median angle of rotational stress) was significantly correlated with rotational kinematics (rotational axis of the femur relative to the tibia throughout the range of motion) at all measured angles after TKA. The correlation coefficients between the median angle of rotational stress and rotational kinematics were 0.97, 0.80, 0.74, 0.71, and 0.70 at 0, 30, 45, 60, and 90 degrees of flexion, respectively (p-values <0.0001 in all measured angles). The correlation coefficient increased as the knee approached full extension. Our findings suggest that soft-tissue balance is a key factor for rotational kinematics, following both cruciate-retaining and posterior-stabilized TKA.

Intraoperative Soft Tissue Balance Reflects Minimum 5-Year Midterm Outcomes in Cruciate-Retaining and Posterior-Stabilized Total Knee Arthroplasty

2012 ◽  
Vol 27 (9) ◽  
pp. 1723-1730 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Hirotsugu Muratsu ◽  
Seiji Kubo ◽  
Takehiko Matsushita ◽  
Masahiro Kurosaka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Cruciate Retaining ◽  
Total Knee

scholarly journals Soft tissue balance using the tibia first gap technique with navigation system in cruciate-retaining total knee arthroplasty

2011 ◽  
Vol 36 (5) ◽  
pp. 975-980 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Hirotsugu Muratsu ◽  
Seiji Kubo ◽  
Takehiko Matsushita ◽  
Kazunari Ishida ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Soft Tissue Balance ◽  
Cruciate Retaining ◽  
Gap Technique ◽  
Total Knee

Soft Tissue Balance Measurement in Posterior-Stabilized Total Knee Arthroplasty With a Navigation System

2009 ◽  
Vol 24 (3) ◽  
pp. 358-364 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Hirotsugu Muratsu ◽  
Nobuhiro Tsumura ◽  
Kiyonori Mizuno ◽  
Masahiro Kurosaka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Total Knee

Intraoperative Soft Tissue Balance/Kinematics and Clinical Evaluation of Modified Kinematically versus Mechanically Aligned Total Knee Arthroplasty

2019 ◽  
Vol 33 (08) ◽  
pp. 777-784 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Koji Takayama ◽  
Kazunari Ishida ◽  
Yuichi Kuroda ◽  
Masanori Tsubosaka ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Soft Tissue Balance ◽  
Cruciate Retaining ◽  
Tibial Internal Rotation ◽  
Tibial Cut ◽  
Total Knee

AbstractRecently, kinematically aligned total knee arthroplasty has been found to achieve better clinical outcomes than mechanically aligned TKA. Despite the good clinical outcomes that are reported at short- to mid-term follow-up, intraoperative variables that are associated with a better outcome have not been measured. Therefore, this study was conducted to compare intraoperative kinematics/soft tissue balance and the clinical outcomes of patients who underwent modified kinematically (restricted tibial cut) or mechanically aligned total knee arthroplasty. Sixty cruciate-retaining total knee arthroplasties (30 modified kinematically [3-degree varus and 7-degree posterior slope in tibial cut] and 30 mechanically aligned) were performed in patients with varus-type osteoarthritis using a navigation system. Intraoperative kinematics assessed by the navigation system and soft tissue balance assessed by an offset-type tensor were compared between the groups. One year postoperatively, the range of motion and 2011 Knee Society scores were compared between the groups. Kinematic assessment exhibited that tibial internal rotation during flexion was significantly maintained in the kinematic compared with the mechanical group (p < 0.05). Varus/valgus ligament balance at 90 and 120 degrees of flexion significantly maintained lateral laxity in the kinematic compared with the mechanical group (p < 0.05). Improvement of flexion angles, functional activity scores, and patient satisfaction were significantly better in the kinematic than in the mechanical group (p < 0.05). Modified kinematically aligned cruciate-retaining total knee arthroplasty maintained more tibial internal rotation and lateral laxity during flexion than mechanically aligned total knee arthroplasty; thus, the former may result in better clinical outcomes.

Joint Gap Kinematics in Posterior-Stabilized Total Knee Arthroplasty Measured by a New Tensor With the Navigation System

2006 ◽  
Vol 128 (6) ◽  
pp. 867-871 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Hirotsugu Muratsu ◽  
Nobuhiro Tsumura ◽  
Kiyonori Mizuno ◽  
Ryosuke Kuroda ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Knee Flexion ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Knee Motion ◽  
Joint Gap ◽  
Total Knee

Background: The management of soft tissue balance during surgery is essential for the success of total knee arthroplasty (TKA) but remains difficult, leaving it much to the surgeon’s feel. Previous assessments for soft tissue balance have been performed under unphysiological joint conditions, with patellar eversion and without the prosthesis only at extension and 90 deg of flexion. We therefore developed a new tensor for TKA procedures, enabling soft tissue balance assessment throughout the range of motion while reproducing postoperative joint alignment with the patellofemoral (PF) joint reduced and the tibiofemoral joint aligned. Our purpose in the present study was to clarify joint gap kinematics using the tensor with the CT-free computer assisted navigation system. Method of Approach: Joint gap kinematics, defined as joint gap change during knee motion, was evaluated during 30 consecutive, primary posterior-stabilized (PS) TKA with the navigation system in 30 osteoarthritic patients. Measurements were performed using a newly developed tensor, which enabled the measurement of the joint gap throughout the range of motion, including the joint conditions relevant after TKA with PF joint reduced and trial femoral component in place. Joint gap was assessed by the tensor at full extension, 5 deg, 10 deg, 15 deg, 30 deg, 45 deg, 60 deg, 90 deg, and 135 deg of flexion with the patella both everted and reduced. The navigation system was used to obtain the accuracy of implantations and to measure an accurate flexion angle of the knee during the intraoperative joint gap measurement. Results: Results showed that the joint gap varied depending on the knee flexion angle. Joint gap showed an accelerated decrease during full knee extension. With the PF joint everted, the joint gap increased throughout knee flexion. In contrast, the joint gap with the PF joint reduced increased with knee flexion but decreased after 60 deg of flexion. Conclusions: We clarified the characteristics of joint gap kinematics in PS TKA under physiological and reproducible joint conditions. Our findings can provide useful information for prosthetic design and selection and allow evaluation of surgical technique throughout the range of knee motion that may lead to consistent clinical outcomes after TKA.

The influence of intraoperative soft tissue balance on patellar pressure in posterior-stabilized total knee arthroplasty

The Knee ◽  
2016 ◽  
Vol 23 (3) ◽  
pp. 540-544 ◽  
Author(s):  
Tomoyuki Matsumoto ◽  
Nao Shibanuma ◽  
Koji Takayama ◽  
Hiroshi Sasaki ◽  
Kazunari Ishida ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Soft Tissue Balance ◽  
Posterior Stabilized ◽  
Total Knee
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