Altmetric

Posterior capsular release is a biomechanically safe procedure to perform in total knee arthroplasty

File Description SizeFormat 
Athwal2018_Article_PosteriorCapsularReleaseIsABio.pdfPublished version942.41 kBAdobe PDFView/Open
Title: Posterior capsular release is a biomechanically safe procedure to perform in total knee arthroplasty
Authors: Athwal, K
Milner, P
Bellier, G
Amis, AA
Item Type: Journal Article
Abstract: Purpose Surgeons may attempt to strip the posterior capsule from its femoral attachment to overcome flexion contracture in total knee arthroplasty (TKA); however, it is unclear if this impacts anterior–posterior (AP) laxity of the implanted knee. The aim of the study was to investigate the effect of posterior capsular release on AP laxity in TKA, and compare this to the restraint from the posterior cruciate ligament (PCL). Methods Eight cadaveric knees were mounted in a six degree of freedom testing rig and tested at 0°, 30°, 60° and 90° flexion with ± 150 N AP force, with and without a 710 N axial compressive load. After the native knee was tested, a deep dished cruciate-retaining TKA was implanted and the tests were repeated. The PCL was then cut, followed by releasing the posterior capsule using a curved osteotome. Results With 0 N axial load applied, cutting the PCL as well as releasing the posterior capsule significantly increased posterior laxity compared to the native knee at all flexion angles, and CR TKA states at 30°, 60° and 90° (p < 0.05). However, no significant increase in laxity was found between cutting the PCL and subsequent PostCap release (n.s.). In anterior drawer, there was a significant increase of 1.4 mm between cutting the PCL and PostCap release at 0°, but not at any other flexion angles (p = 0.021). When a 710 N axial load was applied, there was no significant difference in anterior or posterior translation across the different knee states (n.s.). Conclusions Posterior capsular release only caused a small change in AP laxity compared to cutting the PCL and, therefore, may not be considered detrimental to overall AP stability if performed during TKA surgery. Level of evidence Controlled laboratory study.
Issue Date: 1-May-2019
Date of Acceptance: 3-Aug-2018
URI: http://hdl.handle.net/10044/1/63265
DOI: https://dx.doi.org/10.1007/s00167-018-5094-0
ISSN: 0942-2056
Publisher: Springer Verlag
Start Page: 1587
End Page: 1594
Journal / Book Title: Knee Surgery, Sports Traumatology, Arthroscopy
Volume: 27
Issue: 5
Copyright Statement: © The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Sponsor/Funder: Smith & Nephew Orthopaedics AG
Biomet Inc.
Funder's Grant Number: ASDSWHQ-GR-379
No ref. Provided
Keywords: Science & Technology
Life Sciences & Biomedicine
Orthopedics
Sport Sciences
Surgery
Knee replacement
Posterior capsule release
Stability
Total knee arthroplasty
FLEXION CONTRACTURE
ANTEROPOSTERIOR
RECONSTRUCTION
LIGAMENTS
RESECTION
LAXITY
MOTION
RANGE
Knee replacement
Posterior capsule release
Stability
Total knee arthroplasty
Aged
Arthroplasty, Replacement, Knee
Biomechanical Phenomena
Cadaver
Female
Femur
Humans
Joint Capsule Release
Joint Dislocations
Joint Instability
Knee Joint
Knee Prosthesis
Male
Middle Aged
Osteotomy
Posterior Cruciate Ligament
Pressure
Range of Motion, Articular
Stress, Mechanical
Posterior Cruciate Ligament
Femur
Knee Joint
Humans
Joint Instability
Cadaver
Range of Motion, Articular
Arthroplasty, Replacement, Knee
Osteotomy
Knee Prosthesis
Stress, Mechanical
Pressure
Aged
Middle Aged
Female
Male
Joint Capsule Release
Biomechanical Phenomena
Joint Dislocations
Orthopedics
1103 Clinical Sciences
1106 Human Movement and Sports Sciences
Publication Status: Published
Online Publication Date: 2018-08-09
Appears in Collections:Faculty of Engineering
Mechanical Engineering



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Creative Commons