Effect of posterior cruciate ligament recession on knee joint pressure and joint space measured by an electronic pressure sensor during total knee arthroplasty

2020 ◽  
Author(s):  
Ran Zhao ◽  
Yanqing Liu ◽  
Hua Tian
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Cruciate Ligament ◽  
Lateral Compartment ◽  
Joint Space ◽  
Electronic Pressure ◽  
Total Knee ◽  
Pressure Changes ◽  
Flexion And Extension

Abstract Purpose: The purpose of this study was to evaluate the change in posterior cruciate ligament (PCL) tension by directly measuring the pressure changes in the knee joint when the ligament was released or resected during total knee arthroplasty (TKA).Methods: We prospectively analysed 22 patients who underwent primary TKA (28 knees) between October 2019 and January 2020. The pressure changes in the medial and lateral compartment were measured with an electronic pressure sensor with PCL retention (at 0°, 45°, 90° and 120° of flexion), tibial recession and PCL resection, and changes in the knee joint space were measured.Results: At 0°, 45°, 90° and 120° of flexion, the total pressure in the knee joint after tibial recession of the PCL was significantly higher than with PCL resection, and higher than PCL recession, but only at 120°. Recession or resection of the PCL affected knee joint extension, and the medial/lateral pressure in the knee joint decreased. Pressure in the lateral compartment showed no significant change, while pressure in the medial compartment decreased significantly during knee flexion, which also led to a change in the ratios of the medial and lateral pressures in the knee joint. After resecting the PCL, the mean flexion and extension gaps increased by 0.64 mm and 0.46 mm, respectively.Conclusion: Tibial recession of the PCL can release the PCL while retaining some PCL function. PCL release affects both the flexion and extension gaps, and more cases will increase the flexion gap.

scholarly journals Proximal Fibular Osteotomy – Simplest and Most Effective Mean to Delay Total Knee Arthroplasty

2021 ◽  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Joint Space ◽  
Medial Compartment ◽  
Knee Score ◽  
Fibular Osteotomy ◽  
Number Of Patients ◽  
Total Knee

Background: Osteoarthritis involves degeneration of articular cartilage seen with increasing age. The knee joint, the most common joint that falls prey to attacks of osteoarthritis, has 30% incidence in population above 60 years. Total knee arthroplasty (TKA) is the main surgical option for orthopaedics. Though it corrects the deformity and relieves pain, yet it is not the treatment of choice in younger population. This study aimed to validate the effects of proximal fibular osteotomy (PFO) as a newer technique in managing medial compartment knee osteoarthritis. Methods: The diagnosed patients for medial compartment knee joint osteoarthritis were selected for study from Dr. Ziauddin University hospital of Karachi. Excluded were aged less than 40 years, or with BMI more than 30, and patients with tri-compartmental arthritis. Medial and lateral joint spaces along with Oxford knee score were measured and recorded pre- and post-operatively. Patients underwent PFO after giving written and informed consent. Results: Total number of patients selected was 30 for this study; 21 (70%) females, and 9 (30%) males (mean age 58.8 years). Mean pre-operative measured medial joint space on standard antero-posterior (AP) radiograph was 0.442± 0.04 cm. Mean recorded pre-operative Oxford knee score was 23.87±3.74 mm. Improvement was observed in mean postoperative medial joint space to 0.572± 0 .066 cm and mean post-operative Oxford knee score to 40.2±5.8mm. Conclusion: This study concludes that PFO significantly improves joint function in patients with medial compartment osteoarthritis knee and may delay the need for total knee arthroplasty, if carried out at an appropriate stage. Keywords: Osteotomy; Osteoarthritis; Total Knee Arthroplasty.

scholarly journals Method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Si Yulou ◽  
Xue Yanqin ◽  
Xing Yongjun
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Joint ◽  
Knee Arthroplasty ◽  
Joint Space ◽  
Flexion Contracture ◽  
Soft Tissue Release ◽  
Joint Motion ◽  
Total Knee ◽  
Better Than

AbstractTo discuss the method and effect of total knee arthroplasty osteotomy and soft tissue release for serious knee joint space narrowing. Clinical data of 80 patients from October 2013 to December 2014 was selected with a retrospective method. All patients have undergone total knee arthroplasty. Then the X-rays plain film in weight loading was measured before and after operation and osteotomy was performed accurately according to the knee joint scores and the conditions of lower limb alignments. The average angle of tibial plateau osteotomy of postoperative patients was 4.3°, and the corrective angle of soft tissue balancing was 10.7°; the postoperative patients’ indicies including range of joint motion, knee joint HSS score, angle between articular surfaces, tibial angle, femoral-tibial angle and flexion contracture were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant; the postoperative patients’ flexion contracture and range of joint motion were distinctly better than the preoperative indicies (p<0.05) and the differences were statistically significant. The effective release of the soft tissue of the posterior joint capsule under direct vision can avoid excess osteotomy and get satisfactory knee replacement space without influencing the patients’ joint recovery.

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