Análise do balanceamento ligamentar com aplicação de força manual empírica na artroplastia total de joelho

• Ano de defesa: 2018
• Autor(a) principal: Ferreira, Marcio de Castro [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Artroplastia de Substituição; Articulação do joelho; Doenças articulares; Gap balance; Knee; Soft tissue balance; Subvastus; Tension; Arthroplasty
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=6421983; https://repositorio.unifesp.br/handle/11600/52517

Introduction: Ligament balance in total knee arthroplasty (TKA) is the most important surgical time to promote joint stability. Objetive: To analyze two methods of manual spreader gap assessment accuracy, visual vs blinded, compared with a controlled tensioner in total knee arthroplasty. Methods: Twentytwo fresh frozen cadaver knees were used to perform total knee arthroplasty by 22 surgeons. Extension and flexion gaps were measured with empirical manual force application with spreaders in two different manners: (1) surgeons were blinded to gap geometry formation d blind method group (BM) and (2) surgeons viewed them viewing method group (VM). A tensioner was used to measure the corresponding ligament tension applied during spreader measurements and to measure the extension and flexion gaps with standard force of 100 and 80 N in each femorotibial compartment tensioner method (TM). Results: All measurements with spreaders (VM and BM) presented extension and flexion gaps oversized and asymmetric (p<.0001), when compared with the same gaps measured with the tensioner. Gaps measured in the VM group presented results with slightly less oversizing and asymmetries than the measurements in the BM group compared with TM. Conclusion: The assessment of extension and flexion gaps with empirical manual applied force spreaders produced oversized and asymmetric gaps compared with the use of tensioner. No visual influence was observed during the spreader applied empirical manual force compared with the blinded assessment.