Comput Math Methods Med - A computational modeling approach for investigating soft tissue balancing in bicruciate retaining knee arthroplasty.


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Bicruciate retaining knee arthroplasty, although has shown improved functions and patient satisfaction compared to other designs of total knee replacement, remains a technically demanding option for treating severe cases of arthritic knees. One of the main challenges in bicruciate retaining arthroplasty is proper balancing of the soft tissue during the surgery. In this study biomechanics of soft tissue balancing was investigated using a validated computational model of the knee joint with high fidelity definitions of the soft tissue structures along with a Taguchi method for design of experiments. The model was used to simulate intraoperative balancing of soft tissue structures following the combinations suggested by an orthogonal array design. The results were used to quantify the corresponding effects on the laxity of the joint under anterior-posterior, internal-external, and varus-valgus loads. These effects were ranked for each ligament bundle to identify the components of laxity which were most sensitive to the corresponding surgical modifications. The resulting map of sensitivity for all the ligament bundles determined the components of laxity most suitable for examination during intraoperative balancing of the soft tissue. Ultimately, a sequence for intraoperative soft tissue balancing was suggested for a bicruciate retaining knee arthroplasty.

Resumo Limpo

bicruci retain knee arthroplasti although shown improv function patient satisfact compar design total knee replac remain technic demand option treat sever case arthrit knee one main challeng bicruci retain arthroplasti proper balanc soft tissu surgeri studi biomechan soft tissu balanc investig use valid comput model knee joint high fidel definit soft tissu structur along taguchi method design experi model use simul intraop balanc soft tissu structur follow combin suggest orthogon array design result use quantifi correspond effect laxiti joint anteriorposterior internalextern varusvalgus load effect rank ligament bundl identifi compon laxiti sensit correspond surgic modif result map sensit ligament bundl determin compon laxiti suitabl examin intraop balanc soft tissu ultim sequenc intraop soft tissu balanc suggest bicruci retain knee arthroplasti

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