Posteromedial vertical capsulotomy selectively expands the intraoperative extension gap in cruciate-retaining total knee arthroplasty

Autor: Kensuke Yoshino, Ryutaku Kaneyama, Hitoshi Watanabe, Masaaki Sakamoto, Seiji Ohtori
Rok vydání: 2022
Předmět:
Zdroj: Knee Surgery, Sports Traumatology, Arthroscopy. 31:1347-1353
ISSN: 1433-7347
0942-2056
Popis: Effective soft-tissue balancing procedures for expanding the extension gap (EG) are needed in cases of gap mismatch in total knee arthroplasty (TKA). A posteromedial vertical capsulotomy (PMVC) is performed to restore mobility in a knee with a flexion contracture. The purpose of this study was to evaluate the effectiveness and safety of PMVC for intraoperative gap adjustment in cruciate-retaining TKA.A total of 120 consecutive knees undergoing cruciate-retaining TKA for varus osteoarthritis were examined. The EG and flexion gap (FG) with a trial femoral component were measured using spacer blocks before and after PMVC. PMVC was performed when the first FG was larger than the first EG by 2 mm.Sixty-five knees underwent PMVC, and the mean EG significantly increased by 2.4 mm (p 0.001). This increase was significantly larger than that of the FG by 2.0 mm (p 0.001). The preoperative extension range of motion (ROM) was negatively correlated with the EG change after PMVC (r = - 0.39, p = 0.001). A receiver operating characteristic (ROC) curve indicated a preoperative extension ROM cut-off of -10° for predicting PMVC (sensitivity 72.3%, specificity 56.4%). No associated complications were observed during a minimum 2-year follow-up period, and there was no difference in the postoperative Knee Society Score between the PMVC and non-PMVC groups.PMVC may be a useful soft-tissue treatment for gap adjustment with a selective EG expansion in TKA, especially in cases of a limited preoperative extension of - 10° or less.Therapeutic study, level III.
Databáze: OpenAIRE
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