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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer Berlin Heidelberg

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1434-3916

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Gapbalancing technique combined with patientspec

Authors: Hagen Hommel Carsten Perka
Publish Date: 2015/08/28
Volume: 135, Issue: 11, Pages: 1603-1608
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Abstract

Combining patientspecific instrumentation PSI with a balancer device in total knee arthroplasty TKA to achieve functional femoral rotational alignment is a novel technique The primary goal of this study was to introduce a new method to combine PSI with a gapbalancing technique and to determine the impact of the technique on rotation of the femoral componentTwentyfive primary TKAs 15 women 10 men were prospectively studied All TKAs involved PSI with an associated gapbalancing device Front plane alignment was performed intraoperatively with the PSI followed by rectangular symmetrical extension and creation of a flexion gap using the balancer device to set the femoral rotationFemoral component rotation was between 3° internal and 6° external rotation versus the transepicondylar axis There were no postoperative signs of patellofemoral dysfunction In no cases was the resulting joint line displacement 3 mm The mean elevation was 12 ± 09 mm range 0–3 The leg axis was straight in all cases ±3° at a mean of 16° ± 10° varus range 0°–3° varusPSI was with the gapbalancing technique was successfully used without affecting anatomical alignment With the balancer device PSI can be used more widely than techniques based solely on landmarks as the softtissue tension can be taken into account thus virtually eliminating flexion instabilitiesPreparation of this manuscript was supported by Smith Nephew GmbH Marl Germany Smith Nephew had no involvement in the collection analysis or interpretation of the data in the writing of the report or in the decision to submit the results for publication

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