Department of Orthopaedic Surgery, Korea University School of Medicine, Anam Hospital, 126-1, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea.
Knee Surg Sports Traumatol Arthrosc. 2010 Mar;18(3):381-7. doi: 10.1007/s00167-009-0983-x.
Equalized rectangular extension and flexion gaps are considered desirable to ensure proper kinematics in total knee arthroplasty (TKA). We compared soft tissue balancing in TKAs performed using navigation-assisted gap-balancing (60 knees) and conventional measured resection (56 knees). The outlier of soft tissue balancing was defined as a gap difference >3 mm between the medial and lateral sides in 90 degrees flexion and extension. Medial or lateral outliers in extension or flexion were observed in 12% (7 of 60) navigation TKAs and 25% (14 of 56) conventional TKAs (p = 0.028). There were more outliers in flexion-extension gap difference on the medial side in the conventional (23%) than in the navigation-assisted (5%) group (p = 0.025). However, the proportion of flexion gap difference, extension gap difference, and lateral gap difference outliers did not differ significantly between the two groups (n.s.). Additionally, clinicoradiologic outcomes were similar for the two groups except for the postoperative mechanical axis outlier (p = 0.012). Navigation-assisted soft tissue balancing in TKA reduced not only the postoperative alignment outlier, but also the medial gap difference and achieved a more rectangular flexion and extension gap compared with conventional TKA.
等长矩形伸屈间隙被认为是确保全膝关节置换术（TKA）中适当运动学的理想选择。我们比较了使用导航辅助间隙平衡（60 膝）和常规测量切除（56 膝）进行的 TKA 中的软组织平衡。软组织平衡的离群值定义为 90 度屈伸时内外侧间隙差异>3 毫米。在导航 TKA 中，伸展或屈曲时观察到 12%（7/60）存在内外侧离群值，而在常规 TKA 中为 25%（14/56）（p=0.028）。常规 TKA（23%）中内侧屈伸间隙差异的离群值多于导航辅助（5%）组（p=0.025）。然而，两组之间的屈曲间隙差异、伸展间隙差异和外侧间隙差异的离群值比例没有显著差异（n.s.）。此外，两组的临床放射学结果相似，除了术后机械轴离群值（p=0.012）。与常规 TKA 相比，TKA 中的导航辅助软组织平衡不仅减少了术后对线的离群值，还减少了内侧间隙差异，并实现了更矩形的伸屈间隙。
