Roland Becker, Maximilan Voss, Jonathan Lettner, Robert Hable, Mahmut Enes Kayaalp, Reha Tandogan, Pier Indelli, Nikolai Ramadanov
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引用次数: 0
Abstract
Background: Proper tension of the collateral ligaments is the key to success in total knee arthroplasty (TKA). The study aimed to identify the distraction force for the medial and lateral femorotibial compartments in tension-controlled ligament-balanced TKA at 0° and 90° of knee flexion.
Methods: A literature search was conducted in PubMed up to 31 December 2024 to identify studies that reported exact values of the distraction force applied in tension-controlled ligament-balanced TKA. Mean distraction force at 0° and 90° of knee flexion were calculated for the native knee, cadaver knee, and computer model/artificial knee groups. Differences between groups were calculated using Kruskal-Wallis and Mann-Whitney U tests, with p ≤ 0.05 considered significant. A frequentist meta-analysis of subgroup analysis between native and cadaver knee studies was performed using a random effects model with inverse variance and the Sidik-Jonkman heterogeneity estimator with Hartung-Knapp adjustment to calculate participant age and sex.
Results: Out of 116 included primary studies involved, a total of 6869 participants had distraction force measurements during TKA. The mean distraction force was 149.9 N (35.0-320.0 N) at 0° knee extension and 139.5 N (14.7-244.7 N) at 90° of flexion. Using the Kruskal-Wallis test or the Mann-Whitney U test, there were no significant differences in distraction force between native knee, cadaver knee, computer model/artificial knee studies at extension (p = 0.2480 and p = 0.1130) and at 90° of knee flexion (p = 0.8439 and p = 0.6241).
Conclusion: This meta-analysis is the first to quantify distraction force in TKA, providing essential reference values of 149.9 N at 0° extension and 139.5 N at 90° flexion. These findings offer valuable guidelines for intraoperative soft tissue management during TKA procedures. The consistency of distraction force across different experimental models suggests that these values are broadly applicable. However, it remains unclear whether a more personalized distraction force should be considered for gap preparation.
期刊介绍：
Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication.
The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance.
Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards.
Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).
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