Navigation predictors in determining the frequency of soft tissue release in TKA

摘要

Introduction: The necessity of soft tissue release to achieve a stable, balanced knee in previous publications has a high rate and a wide range of 50-100% of total knee arthroplasty. This reflects disagreement in the indication and the extent of soft tissue release, partly due to lack of standardized quantitative measures of the amount necessary to release, to achieve a stable neutral knee. Consequently, excessive overzealous release may take place, resulting in further instability with added co-morbidity of extra surgery time, extra bleeding and greater potential for future revisions. Recent advances in navigation, with its quantitative real time data of balance and mechanical axis, may standardize and replace the conventional "how good it feels" methods regarding soft tissue balancing. We propose two navigation predictors that quantitatively determine the least amount of soft tissue release necessary to achieve a stable neutral knee, thus reducing the frequency of release, hence, avoiding excessive and unnecessary soft tissue release with its known co-morbidity.