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Related Concept Videos

Adjusting a Traverse01:12

Adjusting a Traverse

298
In the site survey of a four-sided traverse, internal angles are essential to ensure geometric accuracy. The survey revealed that the sum of the measured internal angles was 359 degrees and 48 minutes, which is 12 minutes less than the expected 360 degrees. This discrepancy signals an error likely arising from measurement inaccuracies during the fieldwork.To rectify this error, the adjustment process involved distributing the 12-minute shortfall equally across the four internal angles. By...
298

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Related Experiment Video

Updated: Dec 21, 2025

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
07:33

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

Published on: May 5, 2023

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A gap balancing technique for adjusting the component gap in total knee arthroplasty using a navigation system.

Hiroshi Takagi1, Soshi Asai1, Fumiyoshi Kawashima1

  • 1Department of Orthopedic Surgery, Showa University Fujigaoka Hospital, Japan.

Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology
|May 13, 2020
PubMed
Summary

This study found that adjusting the computer-aided design (CAD) gap during total knee arthroplasty (TKA) using navigation systems accurately reflects the actual component gap, particularly on the medial side, ensuring better implant fit.

Keywords:
Component gapGap balancingNavigation systemTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Surgical Navigation

Background:

  • Assessing component gaps is crucial for implant positioning in total knee arthroplasty (TKA).
  • A modified gap technique utilizes computer-aided design (CAD) virtual gaps adjusted with navigation systems.
  • This technique aims to improve the accuracy of implant placement during TKA.

Purpose of the Study:

  • To compare the virtual gap (CAD-gap) with the actual gap measured after femoral trial component insertion (Trial-gap).
  • To evaluate the clinical usefulness of the modified gap technique using CAD and navigation in TKA.
  • To assess the accuracy of virtual gap estimation in relation to intraoperative measurements.

Main Methods:

  • Thirty-five patients undergoing primary posterior-stabilized TKA with a navigation system were included.
  • The surgical technique involved establishing an extension gap, confirming the virtual flexed CAD-gap, and performing femoral osteotomy.
  • Gap balance was measured using a tensor after femoral component trial insertion, evaluating alignment, rotation, and soft tissue balance.

Main Results:

  • Mean initial alignment was 8.1° varus, femoral component rotation 3.5° external, soft tissue balance 2.7° varus, and final alignment 0.4° varus.
  • Mean medial CAD-gaps were 10.8 mm (extension) and 12.2 mm (flexion); lateral CAD-gaps were 13.7 mm (extension) and 13.9 mm (flexion).
  • Mean medial Trial-gaps were 10.5 mm (extension) and 12.2 mm (flexion); lateral Trial-gaps were 11.4 mm (extension) and 14.4 mm (flexion). A significant difference was noted only in the lateral gap during extension.

Conclusions:

  • The CAD-gap closely approximated the Trial-gap, with only a minor discrepancy in the lateral gap during extension.
  • The virtual gap adjustment technique using navigation systems effectively maintained component gaps in both extension and flexion.
  • This method is particularly useful for accurately adjusting the medial component gap during TKA surgery.