PURPOSE Joint imbalance has become one of the main reasons for early revision after total knee arthroplasty (TKA) and it is directly related to the surgical technique. Therefore, a better understanding of how much bone has to be removed in order to obtain a balanced flexion/extension gap could improve current practice. The primary objective of this study was to analyse the amount of bone that needed to be removed from the distal and posterior femoral joint surfaces in order to obtain an equal flexion/extension gap in robot-assisted TKA. The second objective of this study was to evaluate whether the size of the knee joint influenced the amount of bony resection needed to achieve an equal flexion/extension gap in robot-assisted TKA. METHODS A retrospective analysis was performed on all patients receiving a robot-assisted TKA (Cruciate Retaining (n=268)) by six surgeons from April 2018 to September 2019. The robot was used consecutively when available in all patients receiving Cruciate Retaining TKA. Gap assessment, bony resections, femoral implant size and hip-knee-ankle angle were evaluated with the robot. Femoral implant size was categorized into small (Size 1-2), medium (Size 3-5) and large (Size 6-8). RESULTS The difference between the posterior and distal resection needed to obtain equal flexion and extension gap was on average 2.0 mm (SD 1.6) and 1.5 mm (SD 2.2) for the medial and lateral compartment respectively. The discrepancy was smaller in the large implant group compared to the small implant group (p<.05 medial and lateral) and medium implant group (p<.05 medial). Varus knees required a larger differential resection compared to neutral and valgus knees on the lateral compartment and the contrary on the medial compartment (medial compartment: p < .05 (varus-neutral), p = .051 (varus-valgus); lateral compartment: p < .05 (varus-neutral and varus-valgus)). CONCLUSION Removing an equal amount of bone from the distal and posterior femur will lead to flexion/extension gap imbalance in TKA. It was ...


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    Title :

    Equal bony resection of distal and posterior femur will lead to flexion/extension gap inequality in robot-assisted cruciate-retaining TKA


    Contributors:

    Publication date :

    2021-01-01


    Remarks:

    Knee Surgery, Sports Traumatology, Arthroscopy ; ISSN: 0942-2056 ; ISSN: 1433-7347



    Type of media :

    Article (Journal)


    Type of material :

    Electronic Resource


    Language :

    English



    Classification :

    DDC:    629



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