Short-term results of soft tissue balance obtained with 'manual gap balancing' in varus knees; a prospective study supported by gait analysis

Year 2024, , 226 - 233, 01.07.2024

Fırat Doğruöz , Aliekber Yapar , Ömer Faruk Eğerci , Özkan Köse , Özal Özcan

https://doi.org/10.18663/tjcl.1469649

Abstract

Aim: The aim of this study was to investigate the contribution of medial ligament release using the manual gap balance method in patients with varus deformity to alignment and functional outcomes.
Materials and Methods: The study included 14 female and 8 male patients who underwent total knee arthroplasty. Telemetric radiographs of the lower extremities and valgus stress radiographs of the knees to be operated on were taken for each patient one day before and 1.5 months after the operation. The functional evaluation of patients was conducted using the HSS (Hospital for Special Surgery, 1970) scoring system. Simultaneously, gait analyses were conducted. The patients were divided into groups based on their stress radiographs.
Results: The mean valgus angle in postoperative static radiographs was 2.5 degrees. A statistically significant change in rotational deformity was observed in both swing and stance phases after surgery compared to preoperative values. Improvement in coronal plane varus knees was statistically significant. No significant change was found in the flexion-extension angles of sagittal plane kinematics. It was found that there was a statistically significant difference in the data for single support, double support, and stance percentage (p<0.05).
Conclusion: In conclusion, it was observed that the soft tissue balance achieved through manual gap balancing without the use of technological equipment was sufficient and satisfactory in terms of functional scores, walking parameters, and alignment data.

Keywords

manual gap balancing, varus knee, gait analysis

Ethical Statement

Conflict of Interest The authors declare that they have no conflict of interest. Funding No funding has been received for this research. Ethical Approval The study was approved by Institutional Ethics Committee (Approval number:2015/4-100)

Varus dizlerde 'manuel gap balancing' ile elde edilen yumuşak doku dengesinin kısa dönem sonuçları; yürüyüş analiziyle desteklenen prospektif bir çalışma

Abstract

Amaç: Bu çalışmanın amacı varus deformitesi bulunan hastalarda ‘manual gap balancing’ yöntemi ile yapılan medial bağ gevşetmesinin, dizilime ve fonksiyonel sonuçlara olan katkısını araştırmaktır.
Gereç ve Yöntemler: Çalışmaya total diz artroplastisi uygulanan 14 kadın, 8 erkek hasta dahil edildi. Her hastanın alt ekstremite koronal plan telemetrik grafileri ve opere edilecek dizlerinin valgus stress grafileri operasyondan 1 gün önce ve operasyondan 1,5 ay sonra çekildi. Hastaların fonksiyonel değerlendirmesi HSS (Hospital for Special Surgery, 1970) skorlama sistemi kullanılarak yapıldı. Eş zamanlı olarak hastaların yürüme analizleri yapıldı. Hastalar stress grafilerine göre gruplara ayrıldı.
Bulgular: Postoperatif statik radiografilerdeki valgus açı ortalaması 2,5 derece idi. Koronal planda varus dizlerdeki düzelme istatistiksel olarak anlamlı idi. Dizdeki rotasyonel deformitedeki değişimin ameliyat sonrası, ameliyat öncesi değerlere göre hem salınım hemde basma fazında istatistiksel olarak anlamlı olduğu görüldü. Sagittal plan kinematiklerinden fleksiyon ekstansiyon açılarında anlamlı bir değişim saptanmadı. Tek destek, çift destek ve stance yüzdesi verilerindeki farklılığın istatistiksel olarak anlamlı olduğu saptandı (p<0,05).
Sonuç: Bu çalışma sonucunda, teknolojik ekipmanlar kullanmadan , ‘manual gap balancing’ ile elde edilen yumuşak doku dengesinin, fonksiyonel skorlar, yürüme parametreleri ve dizilim verileri ışığında yeterli ve tatminkar olduğunu görüldü.

Keywords

Manuel bağ dengesi, varus diz, yürüme analizi

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