Does ligament balancing technique affect kinematics in rotating platform, PCL retaining knee arthroplasties? A prospective randomized study

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 16; no. 2; pp. 160 - 166
• Main Authors: Gamada, K., Jayasekera, N., Kashif, F., Fennema, P., Schmotzer, H., Banks, S. A.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.02.2008; Springer Nature B.V
• Subjects: Aged; Arthroplasty, Replacement, Knee - methods; Biomechanical Phenomena; Design; Double-Blind Method; Female; Humans; Joint replacement surgery; Kinematics; Knee; Knee Joint - physiology; Knee Joint - surgery; Ligaments; Ligaments, Articular - surgery; Male; Medicine; Medicine & Public Health; Orthopedic Equipment; Orthopedics; Posterior Cruciate Ligament; Postoperative Period; Prospective Studies; Prostheses; Range of Motion, Articular - physiology; Review boards; Rotation; United Kingdom > UK; Switzerland; Knee kinematics; TKA; Spreader balancing device; Rotating platform; Randomized control trial; Soft tissue balancing
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-007-0447-0

The goal of this prospective, randomized, blinded trial was to determine if ligament balancing techniques for rotating platform TKA affect postoperative knee kinematics. Sixteen patients with unilateral rotating platform TKA consented to participate in this institutional review board approved study. Eight patients were randomly selected to receive ligament balancing with an instrumented joint spreader device and eight patients received ligament balancing using fixed thickness spacer blocks. A single plane shape matching technique was used for kinematic analysis of static deep knee flexion and dynamic stair activities. There were no differences in knee kinematics between groups during static deep flexion activities. The spreader group demonstrated kinematics more similar to the normal knee during the ascending phase of the dynamic stair activity. Knee kinematics in static knee flexion were unaffected by ligament balancing technique, while knees balanced with the spreader demonstrated a medial pivot motion pattern during stair ascent. This medial pivot motion pattern may improve long-term results by more closely replicating normal knee kinematics.