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Published on: November 9, 2018
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Functional stability: an experimental knee joint cadaveric study on collateral ligaments tension.
Bernardo Innocenti1, Edoardo Bori2, Thomas Paszicsnyek3
1BEAMS Department, Bio Electro and Mechanical Systems, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Av. F. Roosevelt, 50 CP165/56, 1050, Bruxelles, Belgium. bernardo.innocenti@ulb.be.
Archives of Orthopaedic and Trauma Surgery
|May 28, 2021
Summary
Achieving functional stability in knee replacement requires 40-50 N tension for intact knees and slightly more for knees with resected cruciate ligaments. Surgeons should avoid both ligament laxity and over-tension during total knee arthroplasty.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Biomedical Engineering
Background:
- Proper collateral ligament tension is crucial for optimal total knee arthroplasty (TKA) outcomes, preventing instability or pain.
- Defining and achieving "functional stability" intraoperatively is essential for successful TKA.
- This study experimentally determined the minimum tension needed for knee functional stability.
Purpose of the Study:
- To measure the minimum tension required to achieve functional stability in knee joints.
- To compare tension requirements across intact, ACL-resected, and ACL & PCL-resected knee specimens.
- To provide data for optimizing intraoperative tensioning during TKA.
Main Methods:
- Investigated ten cadaveric knee specimens using a custom loading frame.
- Measured tension forces during controlled displacement at various flexion angles.
- Assessed joint stability by analyzing force/displacement curve slope changes.
Main Results:
- Intact knees required 40-50 N tension for stability.
- Similar tension levels were sufficient for ACL-resected knees.
- Cruciate ligament resection (ACL & PCL) necessitated higher tensions (up to 60 N), especially at 60° flexion.
Conclusions:
- The experimentally determined tensions for knee stability are lower than those typically applied with surgical tensioners.
- Surgeons should utilize these findings to avoid under- or over-tensioning ligaments during TKA.
- Adhering to optimal tension promotes better functional stability and patient outcomes post-TKA.
