Abstract
Background and Purpose
Soft-tissue balancing is crucial in total knee arthroplasty, but proper release of medial collateral ligament is a challenging procedure. It has been well recognized that medial gap tends to be more tight than lateral gap in varus knees after surgery. The purpose of this study is to investigate the incidence and predictable factors of medial tibial bone remodeling following navigation-assisted total knee arthroplasty.
Materials and methods
One hundred and sixty-six consecutive patients (221 knees) who underwent navigation-assisted total knee arthroplasty and followed during a minimum of 1 year were included in this study. Radiographic examination including anteroposterior and lateral view of both knees were performed at a regular follow-up schedules of 6 weeks, 3 months, 6 months, 1 year and thereafter, annually after surgery. An independent investigator identified the presence of medial tibial bone remodeling at each follow-up. All information on potential factors affecting medial tibial remodeling were retrieved and classified into 2 types (patient- and surgery-related).
Results
Medial tibial bone remodeling was observed in 18% (39/221 knees) and all of them were initially detected between 6 weeks and 6 months after surgery. Of the 15 variables tested, the difference between medial extension gap after bone cutting and total thickness of prostheses is significantly associated with medial tibial bone remodeling. In addition, when the cut-off value was defined as −2.5 mm on Receiver Operating Characteristic curve, the most significant p-value was determined.
Conclusion
The medial tibial bone remodeling was observed in 18% after navigation-assisted total knee arthroplasty. In these cases, the thickness of implanted prostheses showed a strong tendency to be larger than the medial extension gap after bone cutting.
