How Effective Is Multiple Needle Puncturing for Medial Soft Tissue Balancing During Total Knee Arthroplasty? A Cadaveric Study

Abstract We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (...

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Bibliographic Details
Published in:The Journal of arthroplasty 2014-12, Vol.29 (12), p.2478-2483
Main Authors: Koh, In Jun, MD, Kwak, Dai-Soon, PhD, Kim, Tae Kyun, MD, PhD, Park, In Joo, MD, In, Yong, MD, PhD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthroplasty, Replacement, Knee - methods
Cadaver
Female
gap balancing
Humans
Knee - surgery
Knee Joint - surgery
Male
medial collateral ligament
multiple needle puncturing
Needles
Orthopedics
Osteoarthritis, Knee - surgery
Punctures - instrumentation
total knee arthroplasty
varus
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Summary:Abstract We investigated the quantitative effect and risk factors for over-release during multiple needle puncturing (MNP) for medial gap balancing in varus total knee arthroplasty (TKA). Of the ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo MNP in extension (E group), while the other knee underwent MNP in flexion (F group). The increased extension and 90° flexion gaps after every five needle punctures were measured until over-release occurred. The extension gap (< 4 mm) and the 90° flexion gap (< 6 mm) gradually increased in both groups. The 90° flexion gaps increased more selectively than did the extension gaps. MNP in the flexed knee, a narrow MCL, and severe osteoarthritis were associated with a smaller number of MNPs required to over-release.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2013.11.004