Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan,
Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10):2338-45. doi: 10.1007/s00167-013-2376-4. Epub 2013 Jan 16.
In order to permit soft tissue balance under more physiological conditions during total knee arthroplasties (TKAs), an offset-type tensor was developed to obtain soft tissue balancing throughout the range of motion with reduced patello-femoral (PF) and aligned tibiofemoral joints. The main purpose of the present study was to assess intra-operative soft tissue balance using a navigation system with the offset-type tensor in both cruciate-retaining (CR) and posterior-stabilized (PS) TKAs.
One hundred and twenty TKAs--80 CR and 40 PS--were performed in patients with varus-type osteoarthritis using a computed tomography-free navigation system. The offset-type TKA tensor with a reduced and repaired PF joint and femoral component in place was used with the tibia first gap technique to balance soft tissues (joint component gap and ligament balance) at 0°, 10°, 30°, 60°, 90°, and 120° of flexion. The achievement in equalized rectangular gap at extension and flexion--joint component gap within ±3 mm between extension and flexion and ligament balance within ±3° at extension and flexion--was assessed retrospectively.
Both types of implants showed similar patterns of soft tissue balance throughout the range of motion, whereas PS TKA had larger values especially at 60° or 90° of flexion than did CR TKA. In the achievement of equalized rectangular gaps at extension and flexion, CR TKA was superior to PS TKA.
Using the tibia first gap technique with the tensor allows appropriate soft tissue balancing, especially in CR TKA.
Therapeutic studies, Level II.
为了在全膝关节置换术（TKA）中实现更接近生理状态的软组织平衡，开发了一种偏置式张量来实现整个运动范围内的软组织平衡，减少髌股（PF）和对线的胫股关节的接触。本研究的主要目的是使用带有偏置式张量的导航系统评估保留交叉韧带（CR）和后稳定（PS）TKA 术中的软组织平衡。
120 例膝关节骨关节炎患者（80 例 CR 和 40 例 PS）接受了计算机断层扫描自由导航系统下的 TKA。使用带修复 PF 关节和股骨组件的偏置式 TKA 张量，首先固定胫骨，采用胫骨第一间隙技术平衡软组织（关节组件间隙和韧带平衡）在 0°、10°、30°、60°、90°和 120°屈曲位。回顾性评估伸直和屈曲时相等的矩形间隙的实现情况——关节组件间隙在伸直和屈曲时的差值在±3mm 以内，以及在伸直和屈曲时的韧带平衡差值在±3°以内。
两种类型的植入物在整个运动范围内都显示出相似的软组织平衡模式，而 PS TKA 在 60°或 90°屈曲时的数值明显大于 CR TKA。在伸直和屈曲时实现相等的矩形间隙方面，CR TKA 优于 PS TKA。
使用胫骨第一间隙技术和张量可以实现适当的软组织平衡，特别是在 CR TKA 中。
治疗研究，II 级。
