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Redefining Knee Balance in a Medially Stabilized Prosthesis: An In-Vitro Study
Philippe Van Overschelde1, Vera Pinskerova2, Peter P Koch3
1AZ Maria Middelares, Buitenring Sint-Denijs 30, 9000 Gent , Belgium.
The Open Orthopaedics Journal
|January 2, 2018
Summary
Preserving anterior fibers of the superficial medial collateral ligament (sMCL) and iliotibial band (ITB) is crucial for total knee arthroplasty (TKA) stability with medially stabilized implants. Selective release of soft tissues can be performed without compromising sagittal stability.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Biomedical engineering
Background:
- Consensus is lacking on soft tissue preservation during total knee arthroplasty (TKA) with medially stabilized implants.
- Understanding tissue release is vital for successful TKA outcomes.
Purpose of the Study:
- To investigate the impact of progressive medial and lateral soft tissue release.
- To analyze the effect on knee biomechanics after implantation of a medially stabilized prosthesis.
Main Methods:
- Utilized six cadaveric specimens for kinematic and laxity analysis.
- Measured changes in knee balance at three stages: pre-implantation, post-trial implantation, and after progressive soft tissue release.
- Analyzed the incremental effect of each selective release on knee stability.
Main Results:
- Lateral soft tissue release did not affect sagittal stability when the anterior one-third of the iliotibial band (ITB) remained intact.
- Medial soft tissue release was feasible while preserving the anterior fibers of the superficial medial collateral ligament (sMCL).
Conclusions:
- Medially stabilized implants maintain stability if the anterior sMCL and ITB fibers are preserved.
- Sagittal stability is primarily determined by the medial ball-in-socket design of the implant.
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