Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (30): 4828-4832.doi: 10.12307/2021.269

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Gap balance technology can reduce the amount of osteotomy and maintain the balance of lower limb alignment and flexion and extension gap in total knee arthroplasty

Chen Hongqiang, Zhou Hua, Chen Debin, Wu Xizhi, Wu Dewei, Zhao Bin   

  1. Department of Orthopedics, Guiyang Fourth People’s Hospital, Guiyang 550002, Guizhou Province, China
  • Received:2020-10-21 Revised:2020-10-24 Accepted:2021-01-07 Online:2021-10-28 Published:2021-07-29
  • Contact: Chen Hongqiang, Associate chief physician, Department of Orthopedics, Guiyang Fourth People’s Hospital, Guiyang 550002, Guizhou Province, China
  • About author:Chen Hongqiang, Associate chief physician, Department of Orthopedics, Guiyang Fourth People’s Hospital, Guiyang 550002, Guizhou Province, China

Abstract: BACKGROUND: Total knee arthroplasty is an effective method for the treatment of end-stage knee osteoarthritis. The key to total knee arthroplasty is to restore the accurate lower limb alignment and good flexion and extension space balance. Gap balance technique and measurement osteotomy technique are two classical osteotomy methods, which methods to choose is still controversial.  
OBJECTIVE: To compare radiographical manifestations of gap balance technique and measurement osteotomy technique in total knee arthroplasty patients, and analyze application effect of gap balance technique in total knee arthroplasty patients.
METHODS:  Clinical data of 118 patients with total knee arthroplasty were retrospectively analyzed, including 42 males and 76 females, aged 53-72 years old. According to intraoperative osteotomy methods, they were divided into gap balance group (61 cases) and measurement osteotomy group (57 cases). In 12-month follow-up, X-ray films were taken to measure the coronal hip-knee-ankle angle, lower line force angle and femoral flexion angle. Visual analogue scale score and American knee society knee score were used to evaluate the pain degree and knee function. This study was approved by the Ethics Committee of Guiyang Fourth People’s Hospital.  
RESULTS AND CONCLUSION: (1) The gap balance group had local infection in three cases. The measurement osteotomy group had local infection in four cases, rejection in one case, and immune reaction in one case. There was no significant difference in complications between the two groups (4.92%, 10.53%, P > 0.05). (2) In 12-month follow-up, knee flexion 90° stress angle of medial and lateral tibiofemoral joint was lower in the gap balance group than that in the measurement osteotomy group (P < 0.001). Coronal hip-knee-ankle angle and lower limb alignment were smaller in the gap balance group than those in the measurement osteotomy group (P < 0.001). Maximum femoral flexion angle was larger in the gap balance group than that in the measurement osteotomy group (P < 0.001). (3) In 12-month follow-up, visual analogue scale scores were lower in the gap balance group than those in the measurement osteotomy group (P < 0.001). American knee society knee score was higher in the gap balance group than that in the measurement osteotomy group (P < 0.01). (4) Results showed that gap balance technology help to maintain a good lower limb alignment and flexion extension gap space, relieve the pain and improve the knee function during total knee arthroplasty.

Key words: knee, osteoarthritis, total knee arthroplasty, gap balance technology, measurement osteotomy, prosthesis, flexion and extension gap balancing, lower limb alignment, pain, joint function

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