Abstract
Background
Intraoperative balancing can be accomplished by either more prevalent but less predictable soft tissue releases, implant realignment through adjustments of bone resection or a combination of both. There is no published study directly comparing these methods.
Objective
To provide a direct comparison between implant realignment and traditional ligamentous release for soft tissue balancing in total knee arthroplasty using both objective kinematic sensor data to document final balance and patient reported outcomes.
Methods
IRB Approved retrospective cohort study of prospectively collected data comparing kinematic sensor data and patient reported outcomes for all consecutive patients that underwent TKA utilizing kinematic sensors with or without robotic assistance performed between August 2012 to April 2017 to allow for a minimum of 12 months clinical follow up.
Results
107 knees met inclusion criteria. Component realignment was utilized more frequently in the robotic surgical technique cohort than the non-robotic, non-navigated cohort due to the increased precision in implant realignment possble. Although KSS and FJS scores showed equivalent outcomes at both the 3-month and 1-year time points, KSS-Function scores at 1-year showed a statistically and clinically significant increase of 11.89 points in the implant realignment cohort compared to the ligamentous release cohort.
Conclusions
A statistically and clinically significant improvement in KSS-Function scores benefiting the implant realignment technique was seen at 1-year post-operatively. This may suggest a benefit to using implant realignment as the ideal balancing strategy in total knee arthroplasty. Further longitudinal studies with increased number of cases should increase statistical power which is needed to further confirm the suggested benefits of the implant realignment balancing technique.
