Sensor-guided Knee Balancing in Posterior-stabilized Total Knee Arthroplasty: A Surgical Description and Report of Medium-term Patient Outcomes

IF 0.2 Q4 ORTHOPEDICS
D. Cohen, Jil A. Wood, S. MacDessi
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引用次数: 0

Abstract

Background: Intraoperative pressure sensors provide the ability to quantify soft tissue balance (STB) and guide balancing interventions in total knee arthroplasty (TKA). The purpose of this study was to validate a sensor-guided knee balancing algorithm for posterior-stabilized TKA and then report medium-term patient-reported outcome measures from a consecutive series of surgeries using this algorithm. Materials and Methods: An algorithm is described for sensor-guided soft tissue releases and bone recuts aiming for quantitative knee balance. The coprimary endpoints were the proportion of TKAs in which quantitative STB was achieved using the sensor-guided balancing algorithm and the number of balancing interventions required. Secondary outcomes included change in Knee injury and Osteoarthritis Outcome Score (KOOS) components, rates of manipulations for stiffness, and revision surgery. Results: In a consecutive series of 210 knees, quantitative STB was achieved in 91.9% of cases. Balancing procedures were required in 57.2% (n=120), with 84.3% (n=177) requiring up to 2 balancing interventions to achieve balance. Angular bone recuts were required in 22.9% (n=48) of TKAs. At a minimum of 2 years, there was a statistically significant, clinically meaningful increase in mean KOOS4 of 40.8 (SD=17.5). All ΔKOOS subscales improved. The incidence of manipulation for stiffness and revision surgery at up to 4 years were 3.3% (7/210) and 1.4% (3/210), respectively. Conclusions: Quantitative sensor-guided assessment allows precise attainment of STB using a balancing algorithm of both bone recuts and soft tissue releases. Excellent medium-term improvement in patient-reported outcome measures was achieved with posterior-stabilized TKA using intraoperative sensor-guided balancing interventions.
后稳定全膝关节置换术中传感器引导的膝关节平衡:手术描述和中期患者结果报告
背景:术中压力传感器提供了量化软组织平衡(STB)的能力,并指导全膝关节置换术(TKA)中的平衡干预。本研究的目的是验证用于后稳定TKA的传感器引导的膝关节平衡算法,然后报告使用该算法的连续一系列手术中患者报告的中期结果测量。材料和方法:描述了一种用于传感器引导的软组织释放和骨切割的算法,旨在定量平衡膝关节。主要终点是使用传感器引导的平衡算法实现定量STB的tka比例和所需的平衡干预次数。次要结局包括膝关节损伤和骨关节炎结局评分(oos)组成部分的变化、僵硬操作率和翻修手术。结果:在连续210个膝关节系列中,91.9%的病例获得定量STB。57.2% (n=120)的患者需要进行平衡治疗,84.3% (n=177)的患者需要进行2次平衡治疗才能达到平衡。22.9% (n=48)的tka患者需要进行角骨切割。在至少2年的时间里,平均KOOS4增加了40.8 (SD=17.5),具有统计学意义和临床意义。所有ΔKOOS子量表都得到改善。在长达4年的时间里,僵硬和翻修手术的发生率分别为3.3%(7/210)和1.4%(3/210)。结论:定量传感器引导的评估可以使用骨切开和软组织释放的平衡算法精确达到STB。术后稳定TKA采用术中传感器引导的平衡干预,在患者报告的结果测量中取得了极好的中期改善。
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来源期刊
CiteScore
0.60
自引率
0.00%
发文量
31
期刊介绍: The purpose of Techniques in Orthopaedics is to provide information on the latest orthopaedic procedure as they are devised and used by top orthopaedic surgeons. The approach is technique-oriented, covering operations, manipulations, and instruments being developed and applied in such as arthroscopy, arthroplasty, and trauma. Each issue is guest-edited by an expert in the field and devoted to a single topic.
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