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Erschienen in: Archives of Orthopaedic and Trauma Surgery 3/2016

01.03.2016 | Knee Arthroplasty

Varus and valgus stress tests after total knee arthroplasty with and without anesthesia

verfasst von: Tadashi Tsukeoka, Yoshikazu Tsuneizumi

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 3/2016

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Abstract

Introduction

Retrospective studies demonstrated inadequate soft tissue balance is associated with the long-term outcome of total knee arthroplasty (TKA). However, most of these studies have evaluated the joint laxity only postoperatively without anesthesia. Therefore information about the effect of anesthesia on knee laxity is important for soft tissue balancing at the time of surgery. This study was conducted to determine how anesthesia affects the varus and valgus stress tests after TKA.

Materials and methods

A consecutive series of 26 patients undergoing staged bilateral TKA was evaluated. Varus and valgus laxity of the knee with the TKA implant was measured a few days before the contralateral TKA without anesthesia and again immediately after the contralateral TKA under spinal anesthesia.

Results

The laxity was significantly increased from 3.0° to 3.6° (p = 0.005) and from 4.7° to 5.7° (p = 0.007) in medial and lateral side, respectively, when the stress tests were performed under anesthesia in comparison to the laxity measured without anesthesia. The major change in laxity (≥3°) was measured in 6 (23 %) patients tested without anesthesia.

Conclusions

Anesthesia significantly influenced knee joint laxity after TKA. The findings of this study suggest that muscular forces impart a stabilizing force across the joint.
Literatur
1.
Zurück zum Zitat Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M (2001) Early failures in total knee arthroplasty. Clin Orthop Relat Res 392:315–318CrossRefPubMed Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M (2001) Early failures in total knee arthroplasty. Clin Orthop Relat Res 392:315–318CrossRefPubMed
2.
Zurück zum Zitat Waslewski GL, Marson BM, Benjamin JB (1998) Early, incapacitating instability of posterior cruciate ligament-retaining total knee arthroplasty. J Arthroplasty 13:763–767CrossRefPubMed Waslewski GL, Marson BM, Benjamin JB (1998) Early, incapacitating instability of posterior cruciate ligament-retaining total knee arthroplasty. J Arthroplasty 13:763–767CrossRefPubMed
3.
Zurück zum Zitat Asano H, Hoshino A, Wilton T (2004) Soft tissue tension in total knee arthroplasty. J Arthroplasty 19:558–561CrossRefPubMed Asano H, Hoshino A, Wilton T (2004) Soft tissue tension in total knee arthroplasty. J Arthroplasty 19:558–561CrossRefPubMed
4.
Zurück zum Zitat Attfield S, Wilton T, Pratt D, Sambatakakis A (1996) Soft tissue imbalance and recovery of proprioception after total knee replacement. J Bone Joint Surg Br 78:540–545PubMed Attfield S, Wilton T, Pratt D, Sambatakakis A (1996) Soft tissue imbalance and recovery of proprioception after total knee replacement. J Bone Joint Surg Br 78:540–545PubMed
5.
Zurück zum Zitat Samatakakis A (1991) Wilton Tm Newton G. Radiographic signs of persistent soft-tissue imbalance after knee replacement J Bone Joint Surg Br 73:751–756 Samatakakis A (1991) Wilton Tm Newton G. Radiographic signs of persistent soft-tissue imbalance after knee replacement J Bone Joint Surg Br 73:751–756
6.
Zurück zum Zitat Takahashi Tm Wada Y, Yamamoto H (1997) Soft-tissue balancing with pressure distribution during total knee arthroplasty. J Bone Joint Surg Br 79:235–239CrossRef Takahashi Tm Wada Y, Yamamoto H (1997) Soft-tissue balancing with pressure distribution during total knee arthroplasty. J Bone Joint Surg Br 79:235–239CrossRef
7.
Zurück zum Zitat Wasielewski R, Galgante J, Leighty R, Natarjan R, Rosenberg A (1994) Wear patterns on retrieved polyethylene tibia inserts and their relationship to technical consideration during total knee arthroplasty. Clin Orthop Relat Res 299:31–43PubMed Wasielewski R, Galgante J, Leighty R, Natarjan R, Rosenberg A (1994) Wear patterns on retrieved polyethylene tibia inserts and their relationship to technical consideration during total knee arthroplasty. Clin Orthop Relat Res 299:31–43PubMed
8.
Zurück zum Zitat Zalzal P, Papini M, Petruccelli D, de Beer J, Winemaker M (2004) An in vivo biomechanical analysis of the soft-tissue envelope of osteoarthritic knee. J Arthroplasty 19:217–223CrossRefPubMed Zalzal P, Papini M, Petruccelli D, de Beer J, Winemaker M (2004) An in vivo biomechanical analysis of the soft-tissue envelope of osteoarthritic knee. J Arthroplasty 19:217–223CrossRefPubMed
9.
Zurück zum Zitat Okamoto S, Okazaki K, Mitsuyasu H, Matsuda S, Iwamoto Y (2013) Lateral soft tissue laxity increases but medial laxity does not contract with varus deformity in total knee arthroplasty. Clin Orthop Relat Res 471:1334–1342PubMedCentralCrossRefPubMed Okamoto S, Okazaki K, Mitsuyasu H, Matsuda S, Iwamoto Y (2013) Lateral soft tissue laxity increases but medial laxity does not contract with varus deformity in total knee arthroplasty. Clin Orthop Relat Res 471:1334–1342PubMedCentralCrossRefPubMed
10.
Zurück zum Zitat Griffin FM, Insall JN, Scuderi GR (2000) Accuracy of soft tissue balancing in total knee arthroplasty. J Arthroplasty 15:970–973CrossRefPubMed Griffin FM, Insall JN, Scuderi GR (2000) Accuracy of soft tissue balancing in total knee arthroplasty. J Arthroplasty 15:970–973CrossRefPubMed
11.
Zurück zum Zitat Zhang LQ, Xu D, Wang G, Hendrix RW (2001) Muscle strength in knee varus and valgus. Med Sci Sports Exerc 33:1194–1199CrossRefPubMed Zhang LQ, Xu D, Wang G, Hendrix RW (2001) Muscle strength in knee varus and valgus. Med Sci Sports Exerc 33:1194–1199CrossRefPubMed
12.
Zurück zum Zitat Ishii Y, Matsuda Y, Noguchi H, Kiga H (2005) Effect of soft tissue tension on measurements of coronal laxity in mobile-bearing total knee arthroplasty. J Orthop Sci 10:496–500CrossRefPubMed Ishii Y, Matsuda Y, Noguchi H, Kiga H (2005) Effect of soft tissue tension on measurements of coronal laxity in mobile-bearing total knee arthroplasty. J Orthop Sci 10:496–500CrossRefPubMed
13.
Zurück zum Zitat Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2003) Coronal laxity in extension in vivo after total knee arthroplasty. J Orthop Sci 8:538–542CrossRefPubMed Ishii Y, Matsuda Y, Ishii R, Sakata S, Omori G (2003) Coronal laxity in extension in vivo after total knee arthroplasty. J Orthop Sci 8:538–542CrossRefPubMed
14.
Zurück zum Zitat Matsuda Y, Ishii Y, Noguchi H, Ishii R (2005) Varus-valgus balance and range of movement after total knee arthroplasty. J Bone Joint Surg Br 87:804–808CrossRefPubMed Matsuda Y, Ishii Y, Noguchi H, Ishii R (2005) Varus-valgus balance and range of movement after total knee arthroplasty. J Bone Joint Surg Br 87:804–808CrossRefPubMed
15.
Zurück zum Zitat Sekiya H, Takatoku K, Takada H, Sasanuma H, Sugimoto N (2009) Postoperative lateral ligamentous laxity diminishes with time after TKA in the varus knee. Clin Orthop Relat Res 467:1582–1586PubMedCentralCrossRefPubMed Sekiya H, Takatoku K, Takada H, Sasanuma H, Sugimoto N (2009) Postoperative lateral ligamentous laxity diminishes with time after TKA in the varus knee. Clin Orthop Relat Res 467:1582–1586PubMedCentralCrossRefPubMed
16.
Zurück zum Zitat Knoop J, van der Leeden M, Roorda LD, Thorstensson CA, van der Esch M, Peter WF, de Rooij M, Lems WF, Dekker J, Steultjens MP (2014) Knee joint stabilization therapy in patients with osteoarthritis of the knee and knee instability: subgroup analyses in a randomized, controlled trial. J Rehabil Med 46:703–707CrossRefPubMed Knoop J, van der Leeden M, Roorda LD, Thorstensson CA, van der Esch M, Peter WF, de Rooij M, Lems WF, Dekker J, Steultjens MP (2014) Knee joint stabilization therapy in patients with osteoarthritis of the knee and knee instability: subgroup analyses in a randomized, controlled trial. J Rehabil Med 46:703–707CrossRefPubMed
17.
Zurück zum Zitat Fehring TK, Valadie AL (1994) Knee instability after total kneearthroplasty. Clin Orthop Relat Res 299:157–162PubMed Fehring TK, Valadie AL (1994) Knee instability after total kneearthroplasty. Clin Orthop Relat Res 299:157–162PubMed
18.
Zurück zum Zitat Okazaki K, Miura H, Matsuda S, Takeuchi N, Mawatari T, Hashizume M, Iwamoto Y (2006) Asymmetry of mediolateral laxity of the normal knee. J Orthop Sci 11:264–266CrossRefPubMed Okazaki K, Miura H, Matsuda S, Takeuchi N, Mawatari T, Hashizume M, Iwamoto Y (2006) Asymmetry of mediolateral laxity of the normal knee. J Orthop Sci 11:264–266CrossRefPubMed
19.
Zurück zum Zitat Sasanuma H, Sekiya H, Takatoku K, Takada H, Sugimoto N (2010) Evaluation of soft-tissue balance during total knee arthroplasty. J Orthop Surg (Hong Kong) 18:26–30 Sasanuma H, Sekiya H, Takatoku K, Takada H, Sugimoto N (2010) Evaluation of soft-tissue balance during total knee arthroplasty. J Orthop Surg (Hong Kong) 18:26–30
Metadaten
Titel
Varus and valgus stress tests after total knee arthroplasty with and without anesthesia
verfasst von
Tadashi Tsukeoka
Yoshikazu Tsuneizumi
Publikationsdatum
01.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 3/2016
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-015-2405-5

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