Soft-tissue balancing with pressure distribution during total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Device Technology

Background:

• Accurate assessment of joint stress is crucial for successful total knee arthroplasty (TKA).
• Traditional methods may not fully capture dynamic pressure distributions during TKA.
• Understanding stress patterns aids in optimizing surgical techniques and implant placement.

Purpose of the Study:

• To evaluate the efficacy of Fuji pressure-sensitive film (Prescale) in measuring joint pressure distribution during TKA.
• To correlate pressure distribution patterns with ligamentous balancing and surgical outcomes.
• To compare outcomes between patients where Prescale was used versus a control group.

Main Methods:

• Fuji Prescale film was used to measure pressure distribution in the tibiofemoral and patellofemoral joints of 63 TKA patients.
• Tibiofemoral stress patterns were classified into four types: normal, varus-valgus instability, rotational malalignment, and combined.
• Medial ligament releases were performed based on Prescale data; patellofemoral analysis and lateral retinaculum release were also assessed.

Main Results:

• The conformity ratio of the contact area between repeated trials was 87.0%.
• The Prescale group showed a significant decrease in the mean valgus stress angle compared to the control group (p < 0.01).
• Lateral retinaculum release did not significantly alter patellar subluxation between groups.

Conclusions:

• Fuji Prescale film is a valuable tool for assessing joint pressure distribution and guiding ligamentous balancing during TKA.
• Utilizing pressure mapping can lead to improved valgus stress reduction and potentially better TKA outcomes.
• Further research may explore the long-term clinical impact of pressure-sensitive film-guided TKA procedures.