Functional medial ligament balancing in total knee arthroplasty

Leo A. Whiteside, Kazuhiko Saeki, William Mihalko

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Function of the anterior and posterior oblique portions of the medial collateral ligament and the posterior capsule in flexion and extension was evaluated in eight knee specimens after posterior cruciate retaining total knee arthroplasty. The posterior oblique portion of the medial collateral ligament was released subperiosteally in four specimens, and the anterior portion was released in four specimens. The medial posterior capsule was released in each group, then the remaining portion of the medial collateral ligament was released. Release of the posterior oblique portion produced moderate laxity at full extension and at 30°flexion, and posterior capsule release produced additional laxity in full extension. Release of the anterior portion produced major laxity at 60°and 90°flexion. Complete medial collateral ligament release increased laxity significantly in both groups in flexion and extension. This rationale was tested in a clinical study of 82 knees (76 patients) in which 62 (76%) required medial collateral ligament release to correct varus deformity during posterior cruciate retaining total knee arthroplasty. Twenty-two knees (35.5%) were tight medially in extension only, and were corrected by releasing the posterior oblique portion. Thirty-one knees (50%) were tight medially in flexion only, and were corrected by releasing the anterior portion. Nine knees (14.5%) were tight medially in flexion and extension and required complete medial collateral ligament release, but three knees (4.8%) remained tight in extension and required medial posterior capsule release to correct flexion contracture and medial ligament contracture. Seventeen (27%) had partial posterior cruciate ligament release to correct excessive rollback of the femoral component on the tibial surface.

Original languageEnglish (US)
Pages (from-to)45-57
Number of pages13
JournalClinical Orthopaedics and Related Research
Issue number380
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

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Collateral Ligaments
Knee Replacement Arthroplasties
Ligaments
Knee
Capsules
Contracture
Posterior Cruciate Ligament
Thigh

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Functional medial ligament balancing in total knee arthroplasty. / Whiteside, Leo A.; Saeki, Kazuhiko; Mihalko, William.

In: Clinical Orthopaedics and Related Research, No. 380, 01.01.2000, p. 45-57.

Research output: Contribution to journalArticle

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