Highlights
- •We measured the gap under two distraction force in total knee arthroplasty.
- •We investigated the factor that affect the gap difference due to distraction force.
- •The gap difference in the lateral compartment was affected by two patient factors.
- •Hip Knee Ankle angle positively correlated in lateral gap at knee flexion 0 degree.
- •The body mass index negatively correlated in lateral gap at knee flexion 90 degree.
Abstract
Background
Soft tissue balance is important for a good clinical result in total knee arthroplasty.
Nevertheless, the appropriate evaluation of the intraoperative gap has not been established.
We investigated the relationship between physical characteristics and gap differences
due to distraction force, in order to determine whether intraoperative adjustment
of the distraction force can be considered based on the physical characteristics of
the patient.
Methods
A total of 115 varus knees in which primary total knee arthroplasty was performed were retrospectively
evaluated. The component gaps were measured under 60 and 80 N. The gap difference
under 60 and 80 N was calculated. We performed a linear regression analysis to determine
the correlation between the gap differences and patient parameters.
Findings
Each gap was significantly larger under 80 N than under 60 N. The component gap difference
is larger in the lateral compartment than in the medial compartment at each knee flexion
angle. The gap difference negatively correlated with preoperative hip–knee–ankle angle
at a knee flexion of 0° and 120° (r = −0.21, −0.19; p = 0.02, 0.05) and positively correlated with BMI in the lateral compartment at a
knee flexion of 90° (r = 0.31, p < 0.001).
Interpretation
The difference in the intraoperative gap due to the joint distraction force was affected
by the preoperative HKA axis angle and the body mass index in the lateral compartment.
Surgeons should consider the effect of preoperative limb alignment and body mass index
in interpreting intraoperative gap measurement.
Keywords
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Article info
Publication history
Published online: September 16, 2022
Accepted:
September 12,
2022
Received:
February 22,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
