A Targeted Approach to Ligament Balancing Using Kinetic Sensors

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Biomechanics

Background:

• Soft-tissue imbalance is a primary cause of revision surgery after total knee arthroplasty (TKA), leading to instability, stiffness, and aseptic loosening.
• Intraoperative sensors provide real-time, quantitative load data to address soft-tissue imbalance during TKA.

Purpose of the Study:

• To examine how targeted ligament releases affect intra-articular loading using multicenter intraoperative sensor data.
• To determine the specific ligament releases required for achieving quantified ligament balance.

Main Methods:

• A multicenter study involving 129 patients undergoing sensor-assisted TKA.
• Collection of medial and lateral loading data at 10°, 45°, and 90° during range of motion, pre-release, during releases, and post-release.
• Recording of ligament release type, release technique, and resultant loading.

Main Results:

• Releases led to decreased and more symmetrical joint loading.
• An average of 2-3 corrective releases (up to 8) were needed to achieve ligament balance.
• Ligament release types correlated with quantified loading changes, aligning with established literature.

Conclusions:

• Objective sensor data can aid surgeons in reducing loading variability.
• This reduction in variability may decrease ligament imbalance and associated complications.
• Sensor-assisted TKA offers a pathway to improved surgical outcomes.