Related Experiment Video
Updated: May 4, 2026
07:33
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
1.3K
How effective is multiple needle puncturing for medial soft tissue balancing during total knee arthroplasty? A
In Jun Koh1, Dai-Soon Kwak2, Tae Kyun Kim3
1Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, Uijeongbu-si, Gyeonggi-do, Korea; Department of Orthopaedic Surgery, The Catholic University of Korea College of Medicine, Seoul, Korea.
The Journal of Arthroplasty
|December 24, 2013
Summary
Multiple needle puncturing (MNP) for knee replacement can lead to over-release. Performing MNP in flexion, along with a narrow medial collateral ligament (MCL) or severe osteoarthritis, increases the risk of over-release during total knee arthroplasty (TKA).
Area of Science:
- Orthopedic surgery
- Biomechanics
- Surgical techniques
Background:
- Medial gap balancing is crucial for successful total knee arthroplasty (TKA).
- Multiple needle puncturing (MNP) is a technique used to achieve desired joint line gaps.
- Over-release of the medial collateral ligament (MCL) can lead to instability after TKA.
Purpose of the Study:
- To quantitatively assess the risk of over-release during MNP for medial gap balancing in varus TKA.
- To identify risk factors associated with over-release during MNP.
Main Methods:
- Ten pairs of cadaveric knees were used.
- One knee per pair underwent MNP in extension (E group), the other in flexion (F group).
- Gaps were measured after every five needle punctures until over-release occurred.
Main Results:
- Both extension and 90° flexion gaps increased with MNP in both groups.
- 90° flexion gaps increased more selectively than extension gaps.
- MNP in flexion, narrow MCL, and severe osteoarthritis were associated with fewer MNPs to over-release.
Conclusions:
- Performing MNP in flexion increases the risk of over-release in TKA.
- Pre-existing knee conditions like a narrow MCL or severe osteoarthritis are risk factors for over-release during MNP.
