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Redefining Knee Balance in a Medially Stabilized Prosthesis: AnIn-VitroStudy
P. Van Overschelde, V. Pinskerova, PP. Koch, C. Fornasieri, S. Fucentese,
Jazyk angličtina Země Nizozemsko
Typ dokumentu časopisecké články
NLK
Bentham Science Publishers OA
od 2007-09-24
PubMed Central
od 2007 do 2018
Europe PubMed Central
od 2007 do 2018
Open Access Digital Library
od 2007-01-01
Open Access Digital Library
od 2007-01-01
Open Access Digital Library
od 2007-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2007
- Publikační typ
- časopisecké články MeSH
Background: To date, there is still no consensus on what soft tissues must be preserved and what structures can be safely released during total knee arthroplasty (TKA) with a medially stabilized implant. Objective: The aim of this study was to analyze the effect of a progressive selective release of the medial and lateral soft tissues in a knee implanted with a medially stabilized prosthesis. Method: Six cadaveric fresh-frozen full leg specimens were tested. In each case, kinematic pattern and mediolateral laxity were measured in three stages: firstly, prior to implantation; secondly, after the implantation of the trial components, but before any soft tissue release; and thirdly, progressively as soft tissue was released with the trial implant in place. The incremental impact of each selective release on knee balance was then analyzed. Results: In all cases sagittal stability was not affected by the progressive release of the lateral soft tissue envelope. It was possible to perform progressive lateral release provided the anterior one-third of the iliotibial band (ITB) remained intact. Progressive medial release could be performed on the medial side provided the anterior fibers of the superficial medial collateral ligament (sMCL) remained intact. Conclusion: The medially conforming implant remains stable provided the anterior fibers of sMCL and the anterior fibers of the ITB remain intact. The implant's sagittal stability is mainly dependent on its medial ball-in-socket design.
AZ Maria Middelares Buitenring Sint Denijs 30 9000 Gent Belgium
Charles University 1st Orthopaedic Clinic Faculty of Medicine Prague Czech Republic
Clinique Générale Annecy 4 Chemin de la Tour la Reine 74000 Annecy France
University Hospital Balgrist Forchstrasse 340 8008 Zürich Switzerland
Citace poskytuje Crossref.org
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- $a Background: To date, there is still no consensus on what soft tissues must be preserved and what structures can be safely released during total knee arthroplasty (TKA) with a medially stabilized implant. Objective: The aim of this study was to analyze the effect of a progressive selective release of the medial and lateral soft tissues in a knee implanted with a medially stabilized prosthesis. Method: Six cadaveric fresh-frozen full leg specimens were tested. In each case, kinematic pattern and mediolateral laxity were measured in three stages: firstly, prior to implantation; secondly, after the implantation of the trial components, but before any soft tissue release; and thirdly, progressively as soft tissue was released with the trial implant in place. The incremental impact of each selective release on knee balance was then analyzed. Results: In all cases sagittal stability was not affected by the progressive release of the lateral soft tissue envelope. It was possible to perform progressive lateral release provided the anterior one-third of the iliotibial band (ITB) remained intact. Progressive medial release could be performed on the medial side provided the anterior fibers of the superficial medial collateral ligament (sMCL) remained intact. Conclusion: The medially conforming implant remains stable provided the anterior fibers of sMCL and the anterior fibers of the ITB remain intact. The implant's sagittal stability is mainly dependent on its medial ball-in-socket design.
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