ArticleZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery2026
[Effect of posteromedial tibial plateau osteophytes on joint gap balance during robot-assisted total knee arthroplasty].
Article in Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the effect of posteromedial tibial plateau osteophytes on intraoperative joint gap balance during robot-assisted total knee arthroplasty (TKA). Methods: A retrospective analysis was performed on the clinical data of 82 patients with knee osteoarthritis who underwent robot-assisted TKA between November 2023 and December 2025. There were 13 males and 69 females, aged 55-83 years with a mean age of 69.1 years. Fourteen patients received left-sided surgery and 42 received right-sided surgery. The preoperative hip-knee-ankle angle was (6.8±1.4)°. After resecting anterior/lateral osteophytes intraoperatively, the robotic system was used to measure the medial/lateral joint gaps at full extension and 90° of knee flexion before osteotomy (planned state) and after osteotomy, which were recorded as medial extension gap (ME), lateral extension gap (LE), medial flexion gap (MF), and lateral flexion gap (LF). The differences (changes) between post-osteotomy gaps and planned gaps were calculated to assess osteotomy accuracy. Patients were stratified into four groups according to posteromedial tibial plateau osteophyte size measured on preoperative CT: no osteophyte, osteophyte size<5 mm, 5-10 mm, and >10 mm. Intergroup differences in the above gap changes were analyzed to evaluate the effect of osteophyte size on joint gap balance. Results: In all 82 patients, joint gaps after osteotomy were significantly larger than the planned gaps ( Conclusion: Osteotomy may alter the planned joint gap balance, and the degree of gap variation is correlated with the size of posteromedial tibial plateau osteophytes. For patients with osteophytes size >10 mm, the planned medial extension gap should decrease by 2 mm during preoperative osteotomy planning to obtain optimal intraoperative gap balance after bone resection.
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