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  4. Ligament balancing in TKA: Evaluation of a force-sensing device and the influence of patellar eversion and ligament release
 
research article

Ligament balancing in TKA: Evaluation of a force-sensing device and the influence of patellar eversion and ligament release

Crottet, Denis
•
Kowal, Jens
•
Sarfert, Sven A.
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2007
Journal of Biomechanics

Ligament balancing in total knee arthroplasty may have an important influence on joint stability and prosthesis lifetime. In order to provide quantitative information and assistance during ligament balancing, a device that intraoperatively measures knee joint forces and moments was developed. Its performance and surgical advantages were evaluated on six cadaver specimens mounted on a knee joint loading apparatus allowing unconstrained knee motion as well as compression and varus–valgus loading. Four different experiments were performed on each specimen. (1) Knee joints were axially loaded. Comparison between applied and measured compressive forces demonstrated the accuracy and reliability of in situ measurements (1.8 N). (2) Assessment of knee stability based on condyle contact forces or varus–valgus moments were compared to the current surgical method (difference of varus–valgus loads causing condyle lift-off). The force-based approach was equivalent to the surgical method while the moment-based, which is considered optimal, showed a tendency of lateral imbalance. (3) To estimate the importance of keeping the patella in its anatomical position during imbalance assessment, the effect of patellar eversion on the mediolateral distribution of tibiofemoral contact forces was measured. One fourth of the contact force induced by the patellar load was shifted to the lateral compartment. (4) The effect of minor and major medial collateral ligament release was biomechanically quantified. On average, the medial contact force was reduced by 20% and 46%, respectively. Large variation among specimens reflected the difficulty of ligament release and the need for intraoperative force monitoring. This series of experiments thus demonstrated the device’s potential to improve ligament balancing and survivorship of total knee arthroplasty. Keywords: Force-sensing device; Ligament balancing; Ligament release; Total knee arthroplasty

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Type
research article
DOI
10.1016/j.jbiomech.2006.08.004
Web of Science ID

WOS:000247191500008

Author(s)
Crottet, Denis
Kowal, Jens
Sarfert, Sven A.
Maeder, Thomas  
Bleuler, Hannes  
Nolte, Lutz-P.
Dürselen, Lutz
Date Issued

2007

Publisher

Elsevier

Published in
Journal of Biomechanics
Volume

40

Issue

8

Start page

1709

End page

1705

Subjects

couches epaisses

•

medical technology

•

total knee arthroplasty

•

thick film sensors

•

force sensors

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LPM  
Available on Infoscience
February 28, 2008
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/19517
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