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Posteromedial vertical capsulotomy selectively increases the extension gap in posterior stabilized total knee arthroplasty

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

In total knee arthroplasty (TKA), it is important to obtain an appropriate flexion–extension gap. The extension gap is expanded by posteromedial vertical capsulotomy (PMVC). This study aimed to evaluate the increase in the extension gap by PMVC using a navigation system.

Methods

In posterior stabilized (PS)-type TKA, PMVC was performed in 37 knees. The medial extension gap at 0° and flexion gap at 90° flexion of the knee joint using the navigation system before and after PMVC were measured.

Results

The extension gap before the PMVC was 5.3 ± 2.9 mm. After PMVC, the extension gap had significantly increased to 8.0 ± 2.8 mm (p < 0.001). In addition, the flexion gap was 8.1 ± 2.7 mm before the PMVC, but it was 8.7 ± 2.8 mm after the PMVC, and the flexion gap was not enlarged (n.s.).

Conclusion

In PS-type TKA, it is possible to obtain selective expansion of about 2.7 mm of the extension gap by PMVC. Therefore, gap balance can be acquired by soft-tissue treatment while preserving the bone. The PMVC was a useful method for acquiring gap balance and preserving the bone stock.

Level of evidence

IV.

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Funding

No external funding was used.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan

    Shin Masuda, Shinichi Miyazawa, Kodama Yuya, Yusuke Kamatski, Hino Tomohito, Okazaki Yoshiki, Okazaki Yuki, Takayuki Furumatsu & Toshifumi Ozaki

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  1. Shin Masuda
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  2. Shinichi Miyazawa
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  3. Kodama Yuya
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  4. Yusuke Kamatski
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  5. Hino Tomohito
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  6. Okazaki Yoshiki
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  7. Okazaki Yuki
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  8. Takayuki Furumatsu
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  9. Toshifumi Ozaki
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Corresponding author

Correspondence to Shin Masuda.

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Conflict of interest

Shinichi Miyazawa received contribution from Teizin Nakashima Medical.

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This article does not contain any studies with human participants performed by any of the authors.

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Masuda, S., Miyazawa, S., Yuya, K. et al. Posteromedial vertical capsulotomy selectively increases the extension gap in posterior stabilized total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 28, 1419–1424 (2020). https://doi.org/10.1007/s00167-019-05511-5

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  • DOI: https://doi.org/10.1007/s00167-019-05511-5

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