Randomized Controlled Trial of Sensor-Guided Knee Balancing Compared to Standard Balancing Technique in Total Knee Arthroplasty.

Autor: Wood TJ; Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada., Winemaker MJ; Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada., Williams DS; Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada., Petruccelli DT; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada., Tushinski DM; Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada., de Beer JV; Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Complex Care and Orthopaedics Program, Hamilton Health Sciences Juravinski Hospital, Hamilton, Ontario, Canada; Hamilton Arthroplasty Group, Hamilton Health Sciences Juraviski Hospital, Hamilton, Ontario, Canada.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2021 Mar; Vol. 36 (3), pp. 953-957. Date of Electronic Publication: 2020 Sep 22.
DOI: 10.1016/j.arth.2020.09.025
Abstrakt: Background: Despite advances in total knee arthroplasty (TKA) technology, up to 1 in 5 patients remain dissatisfied. This study sought to evaluate if sensor-guided knee balancing improves postoperative clinical outcomes and patient satisfaction compared to a conventional gap balancing technique.
Methods: We undertook a prospective double-blind randomized controlled trial of patients presenting for elective primary TKA to determine a difference in TKA soft tissue balance between a standard gap balancing (tensiometer) approach compared to augmenting the balance using a sensor-guided device. The sensor-guided experimental group had adjustments made to achieve a balanced knee to within 15 pounds of intercompartmental pressure difference. Secondary outcomes included differences in clinical outcome scores at 6 months and 1 year postoperative, including the Oxford Knee Score and Knee Society Score and patient satisfaction.
Results: The sample comprised of 152 patients, 76 controls and 76 experimental sensor-guided cases. Within the control group, 36% (27/76) of knees were unbalanced based on an average coronal plane intercompartmental difference >15 pounds, compared to only 5.3% (4/76) within the experimental group (P < .0001). There were no significant differences in 1-year postoperative flexion, Knee Society Score, or Oxford scores. Overall, TKA patient satisfaction at 1 year was comparable, with 81% of controls and experimental cases reporting they were very satisfied (P = .992).
Conclusion: Despite the use of the sensor-guided knee balancer device to provide additional quantitative feedback in the evaluation of the soft tissue envelope during TKA, we were unable to demonstrate improved clinical outcomes or patient satisfaction compared to our conventional gap balancing technique.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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