[Ligament-controlled positioning of the knee prosthesis components]

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Device Technology

Background:

• Total knee replacement aims for physiological motion and high ligament stability.
• Existing prosthetic designs and surgical techniques strive to meet these dual objectives.
• Achieving both optimal kinematics and stability remains a challenge in knee arthroplasty.

Purpose of the Study:

• To present a modified surgical procedure for total knee implantation.
• To integrate intraoperative ligamentous control with preoperative bony landmark referencing.
• To enhance prosthetic component placement within the native ligamentous envelope.

Main Methods:

• A stepwise surgical sequence involving anterior and distal femoral osteotomies.
• Intraoperative control of osteotomy placement and orientation using ligamentous linkages.
• Finalization of extension and flexion gaps through sequential ligament tensioning and referencing ('top-down' and 'bottom-up').

Main Results:

• The described technique integrates bony and ligament-controlled procedures.
• It allows for prosthetic component positioning within the patient's modified ligamentous framework.
• The method is adaptable to various surgical approaches and PCL (Posterior Cruciate Ligament) management strategies.

Conclusions:

• This technique balances bony and ligamentous guidance for total knee replacement.
• It respects the native ligamentous structures to optimize implant fit and function.
• Computer navigation technology may offer further kinematic control and refinement.