Soft tissue balancing in total knee arthroplasty using sensor-guided assessment: is there a learning curve?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Technology

Background:

• Sensor-guided assessment in total knee arthroplasty (TKA) is linked to improved patient outcomes.
• Adoption of this technology is increasing among surgeons.
• The existence of a learning curve for sensor-guided TKA has not been extensively studied.

Purpose of the Study:

• To investigate the learning curve associated with sensor-guided assessment for soft tissue balance in TKA.
• To determine if surgeon experience impacts the effectiveness of sensor-guided knee balancing.

Main Methods:

• A retrospective analysis of 90 consecutive TKA cases was conducted.
• Patients were divided into two groups: the first 45 (group 1) and the last 45 (group 2).
• Intercompartmental pressure differences were measured before and after ligament balancing, with a balanced knee defined as ≤15 pounds difference.

Main Results:

• Group 1 had 10 unbalanced knees, while all knees in group 2 were balanced (P < 0.001).
• No significant difference in operative time was observed between the groups.
• Improved knee balance was noted after approximately 30 cases, as shown by a scatter plot.

Conclusions:

• A learning curve exists for achieving knee balance using sensor-guided assessment in TKA.
• While improvement was observed, the clinical significance of the differences between early and late groups requires further consideration.