Can the need for soft tissue release in total knee replacement be predicted pre-operatively? A study based on...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Navigation

Background:

• Complex and deformed knees often require soft tissue release (STR) during total knee replacement (TKR) to achieve femorotibial gap symmetry.
• Accurate gap balancing is crucial for optimal TKR outcomes.

Purpose of the Study:

• To investigate the potential of surgical navigation to predict the necessity of soft tissue release (STR) in total knee replacement (TKR).

Main Methods:

• A prospective, non-randomized study involving 130 knees utilizing computer-assisted surgery (CAS).
• The varus-valgus stress angle test (VVSAT) was employed to assess the mechanical axis.
• Progressive STR was performed under CAS guidance until femorotibial gap symmetry was achieved.

Main Results:

• Soft tissue release (STR) was performed in 38.5% of cases, with lateral release (LR) in 12 and medial release (MR) in 38 instances.
• STR was more frequently required in cases with a varus axis (44.6%) compared to valgus (27%).
• Pre-existing deformity, male gender, and increased obesity were significantly associated with the need for STR.

Conclusions:

• Pre-operative factors can be identified to predict the need for soft tissue release (STR) during total knee replacement (TKR).
• Surgical navigation offers valuable insights for managing complex knee deformities in TKR.