Gap-balancing technique combined with patient-specific instrumentation in TKA

Archives of Orthopaedic and Trauma Surgery
Hagen Hommel, Carsten Perka

Abstract

Combining patient-specific instrumentation (PSI) with a balancer device in total knee arthroplasty (TKA) to achieve functional femoral rotational alignment is a novel technique. The primary goal of this study was to introduce a new method to combine PSI with a gap-balancing technique and to determine the impact of the technique on rotation of the femoral component. Twenty-five primary TKAs (15 women, 10 men) were prospectively studied. All TKAs involved PSI with an associated gap-balancing device. Front plane alignment was performed intraoperatively with the PSI, followed by rectangular, symmetrical extension and creation of a flexion gap using the balancer device to set the femoral rotation. Femoral component rotation was between 3° internal and 6° external rotation versus the transepicondylar axis. There were no postoperative signs of patellofemoral dysfunction. In no cases was the resulting joint line displacement >3 mm. The mean elevation was 1.2 ± 0.9 mm (range 0-3). The leg axis was straight in all cases (±3°), at a mean of 1.6° ± 1.0° varus (range 0°-3° varus). PSI was with the gap-balancing technique was successfully used without affecting anatomical alignment. With the balancer device, PSI can be used more widely than ...Continue Reading

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Citations

Jan 18, 2017·Archives of Orthopaedic and Trauma Surgery·Kazumasa YamamuraHiroaki Nakamura
Jun 5, 2020·Der Orthopäde·Hagen HommelPeter Fennema
Feb 9, 2017·Archives of Orthopaedic and Trauma Surgery·Eirik AunanStephan M Röhrl
Jul 12, 2018·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Robert Karl ZahnHagen Hommel

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