Clin Orthop Surg.  2012 Sep;4(3):188-192. 10.4055/cios.2012.4.3.188.

Development of a Pneumatic Tensioning Device for Gap Measurement during Total Knee Arthroplasty

• Kwak DS
• Kong CG
• Han SH
• Kim DH
• In Y

• KMID: 1392980
• DOI: http://doi.org/10.4055/cios.2012.4.3.188

Abstract

BACKGROUND
Despite the importance of soft tissue balancing during total knee arthroplasty (TKA), all estimating techniques are dependent on a surgeon's manual distraction force or subjective feeling based on experience. We developed a new device for dynamic gap balancing, which can offer constant load to the gap between the femur and tibia, using pneumatic pressure during range of motion.
METHODS
To determine the amount of distraction force for the new device, 3 experienced surgeons' manual distraction force was measured using a conventional spreader. A new device called the consistent load pneumatic tensor was developed on the basis of the biomechanical tests. Reliability testing for the new device was performed using 5 cadaveric knees by the same surgeons. Intraclass correlation coefficients (ICCs) were calculated.
RESULTS
The distraction force applied to the new pneumatic tensioning device was determined to be 150 N. The interobserver reliability was very good for the newly tested spreader device with ICCs between 0.828 and 0.881.
CONCLUSIONS
The new pneumatic tensioning device can enable us to properly evaluate the soft tissue balance throughout the range of motion during TKA with acceptable reproducibility.

Keyword

Total knee arthroplasty; Soft tissue balancing; Gap measurement; Pneumatic tensor

MeSH Terms

Arthroplasty, Replacement, Knee/*instrumentation/methods
Biomechanics
Equipment Design
Femur/surgery
Humans
Knee Joint/physiology/*surgery
Mechanical Processes
Range of Motion, Articular
Reproducibility of Results
Tibia/surgery

Figure

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  Fig. 1 A conventional spreader was set on the Instron universal tester to quantify the usual amount of a surgeon's manual distraction force.

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  Fig. 2 The new pneumatic tensioning device consists of air connectors, air cylinders, and femoral and tibial plates.

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  Fig. 3 Feasibility testing was performed by placing the new tensioning device into the gap space of the knee joint. The pneumatic force was applied through the air tube and cylinder to the plates.

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