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Femoral Component Alignment Boundaries for Tibia First Gap Balancing using Digital Tensioning Tool

5 pagesPublished: September 26, 2020

Abstract

Achieving a balanced knee is a critical aspect of Total Knee Arthroplasty (TKA). Coronal and axial boundaries for femoral component placement to achieve balance however, are not well defined. Our aim is to investigate the effect of femoral component and long leg coronal and axial alignment on patient outcomes when using a tibia-first gap balancing technique.
All surgeries were performed using the OMNIBotics robot-assisted TKA platform and BalanceBot device. A total of 197 patients were prospectively enrolled into this study and received TKA surgery using the OMNIBotics platform and completed 1-year KOOS outcome scores. Femoral component and tibiofemoral alignment were categorized as inliers or outliers in the coronal and axial planes. Knee Injury and Osteoarthritis Outcome Score (KOOS), and University of California at Los Angeles Activity Scale (UCLA) was collected at 1-year post-op.
No significant differences were found between the KOOS subscores or UCLA outcome and femoral coronal or tibiofemoral coronal and axial alignment. Significant differences were found between the KOOS pain and sports sub-scores and femoral axial alignment (∆ = 5.4, p = 0.007, ∆ = 8.3, p = 0.03 respectively), in which outlier femoral rotation reported higher scores.
Component alignment limits for improved survival and patient outcomes are a source of ongoing debate. The data presented here indicates that when utilizing a tibia-first gap balancing technique, small deviations outside of traditional ±3°alignment boundaries did not negatively affect KOOS or UCLA outcomes, indicating balance may have a stronger link to patient outcome than alignment.

Keyphrases: Component alignment, Joint Balance, PROMS, Total knee arthroplasty

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 288--292

Links:
BibTeX entry
@inproceedings{CAOS2020:Femoral_Component_Alignment_Boundaries,
  author    = {Edgar Wakelin and Sami Shalhoub and Jeffrey Lawrence and John Keggi and Jeffrey DeClaire and Amber Randall and Corey Ponder and Jan Koenig and Christopher Plaskos},
  title     = {Femoral Component Alignment Boundaries for Tibia First Gap Balancing using Digital Tensioning Tool},
  booktitle = {CAOS 2020. The 20th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Ferdinando Rodriguez Y Baena and Fabio Tatti},
  series    = {EPiC Series in Health Sciences},
  volume    = {4},
  pages     = {288--292},
  year      = {2020},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {https://easychair.org/publications/paper/MLNG},
  doi       = {10.29007/9p46}}
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