Clinical Original Article
The comparison of gap balance technique and measured resection technique in total knee arthroplasty
Fan Lin, Yang Dong, Liu Kaiyuan, Gao Qiuming, Li Xiaodong, Jiang Junjie, Wang Chi, Li Guodong
Published 2019-08-01
Cite as Chin J Orthop, 2019, 39(15): 935-943. DOI: 10.3760/cma.j.issn.0253-2352.2019.15.004
Abstract
ObjectiveTo compare the difference in imaging and clinical effects between gap balance technique and measured resection technique in total knee arthroplasty (TKA).
MethodsWe recruited 300 patients undertaking TKA from July 2014 to July 2016. TKA were performed by using gap balance technique or measured resection technique randomly. The intraoperative rotation of femoral prosthesis, changes of joint line, osteotomy volume, preoperative and postoperative KSS score, WOMAC score, VAS and ROM were compared between the two groups.
ResultsA total of 292 patients were included in the present study, and 248 patients were successfully followed up for 2 years. The operation duration of the gap balance group was 65.9±14.1 min, which was significantly less than that of the measured osteotomy group 70.5±16.5 min (t=2.36, P=0.02). The rotation angle α of the femoral prosthesis measured on CT scan postoperative in gap balance group was 0.67°±1.71°, which was significantly smaller than that of the measured resection technique group 1.25°±2.53° ( t=2.12, P=0.03). The external rotation angle β between the osteotomy plate and femoral posterior condyle line in the gap balance group was 1.25°±1.26°, which was significantly greater than that of the measured resection technique 0.28°±0.19° ( t=6.57, P<0.01). The bone cut volume of femoral medial posterior condyle in gap balance group 9.85±1.37 mm showed a statistically difference (t=2.02, P=0.04) compared with that of the measured osteotomy group 9.52±1.19 mm. The KSS score was 83.8±10.2 in the gap balance group after 1 month. It was superior to the measured resection technique group of 80.5±9.4 with statistical significance (t=2.65, P=0.01). The knee ROM was 101.7°±12.7° in the gap balance group at 1 month after surgery, which was better than that in the measured resection technique group 98.2°±11.8° (t=2.25, P=0.03).
ConclusionThe axis of the femoral prosthesis was more consistent with STEA in the gap balance group of TKA. The gap balance group had better ROM and KSS functional scores at the first month after surgery. However, there was no statistical difference in knee function at the 2-year follow-up between the two groups.
Key words:
Arthroplasty, replacement, knee; Osteotomy; Treatment outcome
Contributor Information
Fan Lin
Department of Orthopaedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
Yang Dong
Liu Kaiyuan
Gao Qiuming
Li Xiaodong
Jiang Junjie
Wang Chi
Li Guodong
