Details

Autor(en) / Beteiligte

• Hommel, Hagen
• Perka, Carsten

Titel

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

Ist Teil von

• Archives of orthopaedic and trauma surgery, 2015-11, Vol.135 (11), p.1603-1608

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2015

Quelle

SpringerLink

Beschreibungen/Notizen

• Introduction 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. Materials and methods 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. Results 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). Conclusions 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 techniques based solely on landmarks, as the soft-tissue tension can be taken into account, thus virtually eliminating flexion instabilities.