000			03293nam a22003497a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a1538-8506
040			_aOvid MEDLINE(R)
099			_a38866047
245			_aAn Advanced Knee Simulator Model Can Reproducibly Be Used for Ligament Balancing Training during Total Knee Arthroplasty.
251			_aThe Journal of Knee Surgery. 2024 Jul 05
252			_aJ Knee Surg. 2024 Jul 05
253			_aThe journal of knee surgery
260			_c2024
260			_fFY2024
260			_p2024 Jul 05
265			_saheadofprint
265			_tPublisher
266			_d2024-08-07
266			_z2024/06/12 19:03
520			_aA critical and difficult aspect of total knee arthroplasty (TKA) is ligamentous balancing for which cadavers and models have played a large role in the education and training of new arthroplasty surgeons, although they both have several shortcomings including cost, scarcity, and dissimilarity to in vivo ligament properties. An advanced knee simulator (AKS) model based on computed tomography (CT) scans was developed in the setting of these challenges with cadavers and previous models. In this study, we compared the ligament balancing between AKS and human cadaveric knees to assess the validity of using the AKS for ligament balancing training during TKA. A CT scan of a TKA patient with varus deformity was used to design the AKS model with modular components, using three-dimensional printing. Three fellowship-trained arthroplasty surgeons used technology-assisted TKA procedure to plan and balance three cadaver knees and the AKS model. Medial and lateral laxity data were captured using manual varus and valgus stress assessments for cadavers and the model in an extension pose (10 degrees of flexion from terminal extension) and between 90 and 95 degrees for flexion. After preresection assessments, surgeons planned a balanced cruciate-retaining TKA. Following bony cuts and trialing, extension and flexion ligament laxity values were recorded in a similar manner. Descriptive statistics and Student's t-tests were performed to compare the cadavers and model with a p-value set at 0.05. Preresection medial/lateral laxity data for both extension and flexion were plotted and showed that the highest standard deviation (SD) for the cadavers was 0.67 mm, whereas the highest SD for the AKS was 1.25 mm. A similar plot for trialing demonstrated that the highest SD for the cadavers was 0.6 mm, whereas the highest SD for the AKS was 0.61 mm. The AKS trialing data were highly reproducible when compared with cadaveric data, demonstrating the value of the AKS model as a tool to teach ligament balancing for TKA and for future research endeavors. Copyright Thieme. All rights reserved.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
650			_zAutomated
651			_aMedStar Union Memorial Hospital
656			_aOrthopaedic Surgery Residency
657			_aJournal Article
700			_aSequeira, Sean _bMUMH _cOrthopaedic Surgery Residency _dMD
790			_aLogan S, Sequeira SB, Jerabek SA, Malkani AL, Mahoney OM, Crutcher JP, Mont MA, Faizan A
856			_uhttps://dx.doi.org/10.1055/a-2343-2346 _zhttps://dx.doi.org/10.1055/a-2343-2346
942			_cART _dArticle
999			_c14360 _d14360