An Advanced Knee Simulator Model Can Reproducibly Be Used for Ligament Balancing Training during Total Knee...

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Surgical Simulation

Background:

• Ligamentous balancing is crucial but challenging in total knee arthroplasty (TKA).
• Current training methods using cadavers have limitations like cost, availability, and unrealistic biomechanics.
• There is a need for improved simulation models for TKA training.

Purpose of the Study:

• To compare ligament balancing accuracy between an Advanced Knee Simulator (AKS) and human cadaveric knees.
• To assess the validity of the AKS model for training ligament balancing in TKA.

Main Methods:

• An AKS model was developed using CT scans of a TKA patient with varus deformity and 3D printing.
• Three fellowship-trained surgeons performed simulated TKA on three cadaver knees and the AKS model.
• Medial and lateral laxity data were measured manually under varus/valgus stress in extension and flexion before and after bony cuts and trialing.

Main Results:

• Preresection, the AKS showed higher variability (SD 1.25 mm) than cadavers (SD 0.67 mm).
• Post-trialing, laxity data for the AKS (SD 0.61 mm) were highly reproducible and comparable to cadavers (SD 0.6 mm).
• The AKS demonstrated consistent performance in ligament balancing during the simulated TKA procedure.

Conclusions:

• The Advanced Knee Simulator (AKS) provides highly reproducible ligament balancing results, comparable to cadaveric knees after simulated total knee arthroplasty.
• The AKS model is a valid and valuable tool for training surgeons in TKA ligament balancing.
• The AKS holds potential for future research in TKA biomechanics and surgical technique development.