Can a well balanced soft tissue envelope speed up the postoperative treatment and improve clinical follow-up? A control - pilot study using a dynamic ligament balancing device based on functional stability

3 pages•Published: September 25, 2020

Abstract

Introduction
Worldwide, the number of TKA implants is increasing. Even if registry demonstrate that TKA as high satisfaction rate, there are still between 15 and 20% dissatisfied patients.
Materials and methods
The proper soft tissue balancing is one of the most discussed topics of the last years. We initiated a study using an electronic device („dynamic ligament balancing sensorplate“) to compare the benefit of the measurement of ligament tension, space and position in comparison to a conventional surgical procedure. Beside that, we followed the concept of functional stability, which tells us, that a tension of 40N in total is sufficient to reach proper (functional) joint stability.
This control pilot study was set up as a single surgeon, single center study and consists of 25 patients treated by the use of the sensorplate and a control group of 25 patients, treated in a conventional setup.
We used the following scores for evaluation: OKS, AKSS and FJS, preoperatively and during the FU examinations (postoperative, 6 weeks, 3 months, 6 months and 1 year)
Beside scoring, clinical examination and routine x-ray we performed an EMG testing at all FU dates.
Results
The study was performed between January 2017 and May 2019. The mean age of the patients was in average 72 years, 66 % female and 34 % male. After 1 year, results demonstrate a clear difference in the development of the postoperative situation between dynamic balanced TKA and the control one.
So, the use of such electronic device improving the soft tissue envelope stability, enable a significantly better patient FU, especially in terms of OKS
Discussion
The DLB system is a new option to value and improve the soft tissue envelope tensioning during the surgical TKA operation. It allows to measure ligament tension, slope and joint space all over the entire ROM.
Conclusion
Using an electronic device for measurement is an advanced option to improve patient satisfaction after tka. Like the studies of other existing devices have shown before there is a massive change in the kinematic behaviour of the muscular abilities by using these tools for a better soft tissue balance. The DLB system is another option by showing 3 different measurement results (tension, distance and joint angle) to adapt the implantation procedure to the individual situation of the patient.

Keyphrases: functional stability, ligament balancing, sensor, tka

In: Ferdinando Rodriguez Y Baena and Fabio Tatti (editors). CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 4, pages 234-236.

Links:	https://easychair.org/publications/paper/gxXH
	https://doi.org/10.29007/n8xw