Accuracy of soft tissue balancing in Total Knee Arthroplasty
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To measure the gap pressure objectively, an electronic sensor has been created that is more Effective. Soft tissue balancing is critical for total knee arthroplasty (TKA) performance and is primarily determined by a surgeon-defined assessment (SDA) or a gap-balancer (GB). The aim of this study was to compare the accuracy of soft tissue balancing using SDA and GB to a sensor.

A total of 48 TKA patients (60 knees) were prospectively enrolled. SDA, a GB, and an electronic sensor were used in order to balance soft tissue. Researchers calculated the sensitivity, specificity, and accuracy of the SDA, GB, and sensor data at 0°, 45°, 90°, and 120° flexion by comparing the SDA, GB, and sensor data. The surgeon's output during the sensor introductory process was evaluated using cumulative summation (CUSUM) analysis.

--The sensitivity of SDA was 63.3%, 68.3%, 80.0%, and 80.0% at 0°, 45°, 90°, and 120°, respectively.

--The accuracy of the GB compared with sensor data was 76.7% and 71.7% at 0° and 90°, respectively.

--Cohen’s kappa coefficient for the accuracy of the GB was 0.406 at 0° (moderate agreement) and 0.227 at 90° (fair agreement).

--The CUSUM 0° line achieved good prior performance at case 45, CUSUM 90° and 120° showed a trend toward good prior performance, while CUSUM 45° reached poor prior performance at case 8.

Finally, SDA was found to be a weak predictor of knee balance. While GB improved soft tissue balancing accuracy, it was still less accurate than the sensor, particularly for unbalanced knees. Except at 45° flexion, SDA improved with continued use of the sensor.