Posterior cruciate ligament recruitment affects antero-posterior translation during flexion gap distraction in total knee replacement. An intraoperative study involving 50 patients.
Publication year
2010Number of pages
7 p.
Source
Acta Orthopaedica Scandinavica, 81, 4, (2010), pp. 471-477ISSN
Annotation
01 augustus 2010
Publication type
Article / Letter to editor

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Organization
Rehabilitation
Orthopaedics
Radboudumc Extern
Journal title
Acta Orthopaedica Scandinavica
Volume
vol. 81
Issue
iss. 4
Languages used
English (eng)
Page start
p. 471
Page end
p. 477
Subject
NCEBP 10: Human Movement & FatigueAbstract
BACKGROUND AND PURPOSE: Because of the oblique orientation of the posterior cruciate ligament (PCL), flexion gap distraction could lead to anterior movement of the tibia, which would influence the tibiofemoral contact point. This would affect the kinematics of the TKR. We assessed the flexion gap parameters when the knee is distracted during implantation of a PCL-retaining TKR. Furthermore, the effects of PCL elevation (steep or flat) and collateral ligament releases on the flexion gap parameters were determined. METHODS: During a ligament-guided TKR procedure in 50 knees, the flexion gap was distracted with a double-spring tensor with 200N after the tibia had been cut. The flexion gap height, anterior tibial translation, and femoral rotation were measured intraoperatively using a CT-free navigation system. RESULTS: During flexion gap distraction, the greatest displacement was seen in anterior-posterior direction. Mean ratio between increase in gap height and tibial translation was 1 to 1.9, and was highest for knees with a steep PCL (1 to 2.3). Knees with a flat PCL and knees with a ligament release had a larger increase in PCL elevation when the gap was distracted. INTERPRETATION: When the PCL is tensioned, every extra mm that the flexion gap is distracted can be expected to move the tibia anteriorly by at least 1.7 mm (flat PCL), or more if there is a steep PCL. This changes the tibiofemoral contact point, which may have consequences for polyethylene wear.
This item appears in the following Collection(s)
- Academic publications [227942]
- Electronic publications [107434]
- Faculty of Medical Sciences [86237]
- Open Access publications [76544]
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