Soft-tissue balancing with virtual bone cuts in navigated total knee arthroplasty

摘要

Introduction: Computer assisted surgery (CAS) in Total Knee Arthroplasty (TKA) makes it not only possible to guide the 3 necessary bones cuts (distal femoral, posterior femoral and proximal tibial) but also soft-tissue balancing, and managing their interdependence as best as possible. Recent softwares give us the possibility to assess frontal laxity and to perform "gap management" which can be done now with virtual bone cuts to avoid mistakes in real cuts or residual laxity. Methods: The retrospective study included 30 patients who underwent TKA with Stryker-Leibinger CAS. The procedure used the "Kneetrac 3.2" software which supplies information in two fields : The visualization of frontal laxity, expressed in distances between the condyle and the tibial plateau on each side of the knee and in the HKA difference between varus and valgus stress throughout total flexion/extension. The concept of "global space" between femur and tibia, expressed in height between the condyle and the tibial plateau, as well as a visualization of it's form, in extension and 90?of flexion. This space is measured between two cuts (femoral and tibial), either virtual cuts or cuts that have been actually performed.