Can tibia-first total knee arthroplasty using computer-assisted system improve anterior and posterior knee stability?

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Technology

Background:

• Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
• Restoring knee function and alleviating pain are primary goals of TKA.

Purpose of the Study:

• To evaluate if tibia-first (TF) total knee arthroplasty (TKA) using a novel computer-assisted surgery (CAS) system enhances anterior and posterior (AP) knee stability.
• Comparison of TF-TKA with measured resection (MR)-TKA in terms of ligament balance and AP laxity.

Main Methods:

• A comparative study involving 41 MR-TKAs and 32 TF-TKAs in patients with varus knee osteoarthritis.
• Measurement of varus-valgus ligament balance and joint tension across various knee flexion angles (0-120°).
• Assessment of postoperative knee AP laxity using a Kneelax 3 arthrometer at 30° and 90° flexion.

Main Results:

• TF-TKA demonstrated significantly closer horizontal gap balance than MR-TKA from 0° to 60° flexion.
• No significant difference in joint-gap tensions was found between the groups.
• TF-TKA showed significantly smaller AP laxity at 30° flexion (8.8 ± 2.9 mm vs. 10.7 ± 3.1 mm).

Conclusions:

• TF-TKA utilizing a novel CAS system results in superior AP knee stability.
• The technique achieves improved horizontal gap balance, contributing to better overall knee stability post-surgery.