Evidence map›Paper›PMID 26174467›Full record

Observational studyKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2017

Patient-related factors influence stiffness of the soft tissue complex during intraoperative gap balancing in cruciate-retaining total knee arthroplasty.

P J C Heesterbeek, N Haffner, A B Wymenga, J Stifter, P Ritschl

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Surgeon-defined assessment is a poor predictor of knee balance in total knee arthroplasty: a prospective, multicenter study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021
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  14. Review
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  17. What is a balanced knee replacement?EFORT open reviews · 2018
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  19. Superior long-term survival for fixed bearing compared with mobile bearing in ligament-balanced total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
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  20. Influence of soft tissue balancing and distal femoral resection on flexion contracture in navigated total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

P J C HeesterbeekSint Maartenskliniek Research, Nijmegen, The Netherlands. p.heesterbeek@maartenskliniek.nl.
N HaffnerOrthopedic hospital Gersthof, Vienna, Austria.
A B WymengaSint Maartenskliniek Orthopaedics, Nijmegen, The Netherlands.
J StifterMedivation, Windisch, Switzerland.
P RitschlOrthopedic hospital Gersthof, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeHow much force is needed to pre-tension the ligaments during total knee arthroplasty? The goal of this study was to determine this force for extension and flexion, and for both compartments, and to identify predicting patient-related factors.

methodsEighty patients [55 females, mean age 71 (SD 9.7)] were recruited and had a navigated cruciate-retaining total knee arthroplasty. Distraction of the medial and lateral compartments of the extension and flexion gap (90°) with an instrumented bi-compartmental double-spring tensioner took place after finishing the bone cuts. Applied forces and resulting gap distances were recorded by the navigation system, resulting in a force-elongation curve. Lines were fitted with the intersection defined as the stiffness transition point. The slopes (N/mm) represented the stiffness of the ligamentous complex. Linear multiple regression analysis was performed to identify predicting factors.

resultsThe amount of force at the stiffness transition point was on average 52.3 (CI

conclusionThe amount of force at the stiffness transition point varies between 48 and 59 N, depending on flexion/extension and compartment. Patient-related factors influence the stiffness transition point and can help predict the stiffness transition point. When forces higher than 60 N are used for gap distraction, the ligamentous sleeve of the knee might be over-tensioned. LEVEL OF EVIDENCE: Prognostic study, Level I-high-quality prospective cohort study with >80 % follow-up, and all patients enrolled at same time point in disease.

Indexed as

AdultAgedAged, 80 and overArthroplasty, Replacement, KneeBiomechanical PhenomenaFemaleFollow-Up StudiesHumansKnee JointLigaments, ArticularLinear ModelsMaleMiddle AgedOsteoarthritis, KneePrognosisProspective StudiesComputer navigationCruciate-retaining total knee arthroplastyGap balancingSoft tissue complexTotal knee arthroplasty

Identifiers

PMID26174467

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.