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Achieving a Balanced Knee in Robotic TKA
Open AccessLetter

How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment

1
Coon Joint Replacement Institute: Adventist Health, St. Helena, CA 94574, USA
2
OrthoSensor Inc., Dania Beach, FL 33004, USA
3
Holy Cross Hospital, Fort Lauderdale, FL 33308, USA
4
Department of Structure and Repair, Ghent University, 9000 Ghent, Belgium
*
Author to whom correspondence should be addressed.
Sensors 2021, 21(3), 700; https://doi.org/10.3390/s21030700
Received: 9 December 2020 / Revised: 15 January 2021 / Accepted: 19 January 2021 / Published: 20 January 2021
(This article belongs to the Special Issue Smart Sensors Applications in Total Joint Arthroplasty)
To achieve a balanced total knee, various surgical corrections can be performed, while intra-operative sensors and surgical navigation provide quantitative, patient-specific feedback. To understand the impact of these corrections, this paper evaluates the quantitative impact of both soft tissue releases and bone recuts on knee balance and overall limb alignment. This was achieved by statistically analyzing the alignment and load readings before and after each surgical correction performed on 479 consecutive primary total knees. An average of three surgical corrections were required following the initial bone cuts to achieve a well aligned, balanced total knee. Various surgical corrections, such as an arcuate release or increasing the tibial polyethylene insert thickness, significantly affected the maximum terminal extension. The coronal alignment was significantly impacted by pie-crusting the MCL, adding varus to the tibia, or releasing the arcuate ligament or popliteus tendon. Each surgical correction also had a specific impact on the intra-articular loads in flexion and/or extension. A surgical algorithm is presented that helps achieve a well-balanced knee while maintaining the sagittal and coronal alignment within the desired boundaries. This analysis additionally indicated the significant effect that soft tissue adjustments can have on the limb alignment in both anatomical planes. View Full-Text
Keywords: balancing; surgical corrections; soft tissue releases; mechanical alignment; total knee arthroplasty balancing; surgical corrections; soft tissue releases; mechanical alignment; total knee arthroplasty
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MDPI and ACS Style

Moore, R.E.; Conditt, M.A.; Roche, M.W.; Verstraete, M.A. How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment. Sensors 2021, 21, 700. https://doi.org/10.3390/s21030700

AMA Style

Moore RE, Conditt MA, Roche MW, Verstraete MA. How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment. Sensors. 2021; 21(3):700. https://doi.org/10.3390/s21030700

Chicago/Turabian Style

Moore, Ryan E.; Conditt, Michael A.; Roche, Martin W.; Verstraete, Matthias A. 2021. "How to Quantitatively Balance a Total Knee? A Surgical Algorithm to Assure Balance and Control Alignment" Sensors 21, no. 3: 700. https://doi.org/10.3390/s21030700

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Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

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