Journal of Peking University(Health Sciences) >
Cumulative sum control chart analysis of soft tissue balance in total knee replacement assisted by electronic pressure sensor
Received date: 2020-11-04
Online published: 2023-08-03
Supported by
Beijing Municipal Science & Technology Commission(D171100003217001)
Objective: To explore the training ability of pad to guide the balance of soft tissue by drawing cumulative sum (CUSUM) control chart total knee arthroplasty (TKA) sensor. Methods: The data of 73 knees of TKA assisted by electronic gasket initially completed by a senior physician were analyzed retrospectively. There were 8 males (8 knees) and 52 females (65 knees), with an average age of (67.5±5.9) years (57-82 years). The balance of the internal and external space of knee joint was measured at 0°, 45°, 90°, and 120°, in order to observe the pressure distribution of the medial and la-teral compartments, and CUSUM learning curve was drawn. Results: In 0° extension, the medial pressure was higher than the lateral (P < 0.01), when flexion began, the medial and lateral pressures decreased, and became stable and approximately equal during 45°-120°. In the learning curve, by knee 34, CUSUM 0° curve crossed the acceptable control line from above, which showed that it was easy to grasp the soft tissue balance at 0° position through sensor learning. CUSUM 45° curve was above the unacceptable control line in the end, which meant that it was difficult to grasp the technique at the mid-flexion angle. CUSUM 90° and 120° crossed the acceptable control line from above by knee 68 and 57 respectively, which showed that the technique of balance could be improved with the aid of more cases. Conclusion: The electronic pressure sensor can effectively guide the soft tissue balance in TKA. The learning process is simple and does not increase the risk of complications. It can be used as a tool for learning TKA soft tissue balance technology to guide joint surgeons to further master or improve the soft tissue balance technology.
Ran ZHAO , Yan-qing LIU , Hua TIAN . Cumulative sum control chart analysis of soft tissue balance in total knee replacement assisted by electronic pressure sensor[J]. Journal of Peking University(Health Sciences), 2023 , 55(4) : 658 -664 . DOI: 10.19723/j.issn.1671-167X.2023.04.015
| 1 | ElmallahRK,MistryJB,CherianJJ,et al.Can we really "feel" a balanced total knee arthroplasty?[J].J Arthroplasty,2016,31(Suppl 9):102-105. |
| 2 | GustkeKA,GolladayGJ,RocheMW,et al.Increased satisfaction after total knee replacement using sensor-guided technology[J].Bone Joint J,2014,96-B(10):1333-1338. |
| 3 | BellemansJ,VandenneuckerH,Van LauweJ,et al.A new surgical technique for medial collateral ligament balancing: Multiple needle puncturing[J].J Arthroplasty,2010,25(7):1151-1156. |
| 4 | YapCH,ColsonME,WattersDA.Cumulative sum techniques for surgeons: A brief review[J].ANZ J Surg,2007,77(7):583-586. |
| 5 | WoonCYL,CarrollKM,LymanS,et al.Dynamic sensor-balanced knee arthroplasty: Can the sensor "train" the surgeon?[J].Arthroplast Today,2019,5(2):202-210. |
| 6 | CanovasF,DagneauxL.Quality of life after total knee arthroplasty[J].Orthop Traumatol Surg Res,2018,104(Suppl 1):S41-S46. |
| 7 | Van DammeG,DefoortK,DucoulombierY,et al.What should the surgeon aim for when performing computer-assisted total knee arthroplasty?[J].J Bone Joint Surg Am,2005,87(Suppl 2):52-58. |
| 8 | KhanN,AbboudiH,KhanMS,et al.Measuring the surgical "learning curve": Methods, variables and competency[J].BJU Int,2014,113(3):504-508. |
| 9 | RamsayCR,GrantAM,WallaceSA,et al.Assessment of the learning curve in health technologies. A systematic review[[J].Int J Technol Assess Health Care,2000,16(4):1095-1108. |
| 10 | ZhaoR,LiuY,TianH.Accuracy of soft tissue balancing in total knee arthroplasty using surgeon-defined assessment versus a gap-balancer or electronic sensor[J].J Orthop Surg Res,2021,16(1):305. |
| 11 | 孙晓威,张启栋,任鹏鹏,等.全膝关节置换关节间隙压力传感器的研究现状[J].中国矫形外科杂志,2020,28(19):1774-1778. |
| 12 | GustkeKA,GolladayGJ,RocheMW,et al.A new method for defining balance: Promising short-term clinical outcomes of sensor-guided TKA[J].J Arthroplasty,2014,29(5):955-960. |
| 13 | MacDessiSJ,GharaibehMA,HarrisIA.How accurately can soft tissue balance be determined in total knee arthroplasty?[J].J Arthroplasty,2019,34(2):290-294. e1. |
| 14 | LakraA,SarpongNO,JenningsEL,et al.The learning curve by operative time for soft tissue balancing in total knee arthroplasty using electronic sensor technology[J].J Arthroplasty,2019,34(3):483-487. |
| 15 | MeneghiniRM,Ziemba-DavisMM,LovroLR,et al.Can intra-operative sensors determine the "target" ligament balance? Early outcomes in total knee arthroplasty[J].J Arthroplasty,2016,31(10):2181-2187. |
| 16 | VerstraeteMA,MeerePA,SalvadoreG,et al.Contact forces in the tibiofemoral joint from soft tissue tensions: Implications to soft tissue balancing in total knee arthroplasty[J].J Biomech,2017,58,195-202. |
| 17 | RocheM,ElsonL,AndersonC.Dynamic soft tissue balancing in total knee arthroplasty[J].Orthop Clin North Am,2014,45(2):157-165. |
| 18 | LeDH,GoodmanSB,MaloneyWJ,et al.Current modes of fai-lure in TKA: Infection, instabi-lity, and stiffness predominate[J].Clin Orthop Relat Res,2014,472(7):2197-2200. |
| 19 | StamboughJB,EdwardsPK,MannenEM,et al.Flexion instabi-lity after total knee arthroplasty[J].J Am Acad Orthop Surg,2019,27(17):642-651. |
| 20 | HinoK,KutsunaT,OonishiY,et al.Assessment of the midfle-xion rotational laxity in posterior-stabilized total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2017,25(11):3495-3500. |
| 21 | ParratteS,PagnanoMW.Instability after total knee arthroplasty[J].J Bone Joint Surg Am,2008,90(1):184-194. |
| 22 | VajapeySP,PettitRJ,LiM,et al.Risk factors for mid-flexion instability after total knee arthroplasty: A systematic review[J].J Arthroplasty,2020,35(10):3046-3054. |
| 23 | ClaryCW,FitzpatrickCK,MaletskyLP,et al.The influence of total knee arthroplasty geometry on mid-flexion stability: An expe-rimental and finite element study[J].J Biomech,2013,46(7):1351-1357. |
| 24 | HinoK,IshimaruM,IsekiY,et al.Mid-flexion laxity is greater after posterior-stabilised total knee replacement than with cruciate-retaining procedures: A computer navigation study[J].Bone Joint J,2013,95-B(4):493-497. |
| 25 | EvangelistaPJ,LasterSK,LenzNM,et al.A computer model of mid-flexion instability in a balanced total knee arthroplasty[J].J Arthroplasty,2018,33(Suppl 7):S265-S269. |
| 26 | LuyckxT,VandenneuckerH,IngLS,et al.Raising the joint line in TKA is associated with mid-flexion laxity: A study in cadaver knees[J].Clin Orthop Relat Res,2018,476(3):601-611. |
| 27 | MatziolisG,BrodtS,WindischC,et al.The reversed gap technique produces anatomical alignment with less midflexion instability in total knee arthroplasty: A prospective randomized trial[J].Knee Surg Sports Traumatol Arthrosc,2016,24(8):2430-2435. |
| 28 | MochizukiT,TanifujiO,SatoT,et al.Association between anteroposterior laxity in mid-range flexion and subjective healing of instability after total knee arthroplasty[J].Knee Surg Sports Traumatol Arthrosc,2017,25(11):3543-3548. |
| 29 | BabisGC,TrousdaleRT,MorreyBF.The effectiveness of isolated tibial insert exchange in revision total knee arthroplasty[J].J Bone Joint Surg Am,2002,84(1):64-68. |
| 30 | AbdelMP,PulidoL,SeversonEP,et al.Stepwise surgical correction of instability in flexion after total knee replacement[J].Bone Joint J,2014,96-B(12):1644-1648. |
| 31 | SchwabJH,HaidukewychGJ,HanssenAD,et al.Flexion instability without dislocation after posterior stabilized total knees[J].Clin Orthop Relat Res,2005,440,96-100. |
| 32 | LongoUG,CiuffredaM,ManneringN,et al.Outcomes of posterior-stabilized compared with cruciate-retaining total knee arthroplasty[J].J Knee Surg,2018,31(4):321-340. |
| 33 | van der LindeJA,BeathKJ,LeongAKL.The reliability of sensor-assisted soft tissue measurements in primary total knee arthroplasty[J].J Arthroplasty,2018,33(8):2502-2505. e12. |
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