Name: in vitro application of a wireless sensor in flexion-extension gap balance of unicompartmental knee arthroplasty
Uploaded: 2023-05-05T12:40:00
Description: Watch this Scientific Journal Video about In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty at JoVE.com

This work was supported by Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support [grant numbers: XMLX202139]. We would like to express our gratitude to Diego Wang for valuable suggestions.

The protocol was approved by the Ethics Committee of Xuanwu Hospital (grant number: 2021-224) and was conducted in accordance with the Declaration of Helsinki. Informed consent was obtained from next of kin to use the cadavers.
1. Installation of angle measuring device
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	<li>Turn on the switch of the femur and tibia angle measuring device. Open the angle measurement software on the tablet computer, scan the QR codes of the two measuring devices, and click Bluetoo...

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Mobile-bearing UKA is an effective treatment for anteromedial KOA. It has the advantages of less trauma, quick recovery, and maintaining normal knee proprioception11,12,13. The key to UKA is flexion-extension balance; that is, making the flexion gap and extension gap as equal as possible on the premise of restoring MCL tension14. The imbalance may lead to bearing dislocation, prosthesis wear, or progressi...

Knee osteoarthritis (KOA) is a global burden1, for which the stepwise treatment strategy is currently adopted. For end-stage unicompartmental KOA, unicompartmental knee arthroplasty (UKA) is an effective choice, with a 10-year survival rate of over 90%2. Medial UKA only replaces the severely worn medial compartment and preserves the natural lateral compartment, medial collateral ligament (MCL), and cruciate ligament3. The principle is to make the flexion gap and extension gap approximately the same by tibial osteotomy and femoral grinding, and to restore MCL tension after implantation of the prosthesis and bearing4. Compared with total knee arthroplasty, UKA has greater surgical difficulty and technical requirements. The main source is the proper balance of ligaments throughout the full range of motion of the knee3.
Traditionally, after preliminary osteotomy, the surgeon inserts a gap gauge in the joint space and indirectly determines whether the flexion and extension gaps are equal by feeling the tension of the MCL. However, the definition and sensation of balance are hardly the same, even for experienced surgeons. For beginners, it is more difficult to grasp the requirement of balance. The imbalance of the flexion-extension gap can lead to a series of complications5,6, resulting in an increased revision rate.
With the advancement of technology, some researchers have tried to apply tensors to UKA7,8. However, these researches are all on the fixed-bearing UKA, and the tensor may damage the MCL when used.
The emergence of sensors not only meets the demand for displaying the pressure in the knee joint gap, but various sensors often have less risk of MCL damage due to their small size9,10. In addition, the sensors currently used are all wired transmission, which may interfere with the aseptic operation and is not convenient enough to use.
In order to accurately measure the flexion-extension gap balance parameters, we developed a wireless sensor combination for UKA, which consists of a metal base, a wireless sensor with three pressure probes on the front, medial, and lateral sides, and a cushion block. The sensor combination measures and displays the pressure in the joint space in real time to help surgeons accurately assess whether the balance target has been achieved.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>angle measuring device</td>
			<td>AIQIAO(SHANGHAI) MEDICAL TECHNOLOGY CO., LTD.</td>
			<td>20203010141</td>
			<td>angle measuring device of femur,angle measuring device of tibia</td>
		</tr>
		<tr>
			<td>Oxford Partial Knee System</td>
			<td>Biomet UK LTD.</td>
			<td>20173130347</td>
			<td>Oxford UKA</td>
		</tr>
		<tr>
			<td>Wireless sensor combination</td>
			<td>AIQIAO(SHANGHAI) MEDICAL TECHNOLOGY CO., LTD.</td>
			<td>20212010325</td>
			<td>a metal base,&#160; a wireless sensor with three pressure probes, and a cushion block</td>
		</tr>
	</tbody>
</table>

in vitro application of a wireless sensor in flexion-extension gap balance of unicompartmental knee arthroplasty

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis (AMOA). The key to UKA is the flexion-extension gap balance, which is closely related to postoperative complications such as bearing dislocation, bearing wear, and arthritis progression. The traditional gap balance assessment is performed by indirectly sensing the tension of the medial collateral ligament by a gap gauge. It relies on the surgeon's feel and experience, which is imprecise and difficult for beginners. To accurately assess the flexion-extension gap balance of UKA, we developed a wireless sensor combination consisting of a metal base, a pressure sensor, and a cushion block. After osteotomy, the insertion of a wireless sensor combination allows the real-time measurement of intra-articular pressure. It accurately quantifies the flexion-extension gap balance parameters to guide further femur grinding and tibia osteotomy, to improve the accuracy of gap balance. We conducted an in vitro experiment with the wireless sensor combination. the results showed that there was a difference of 11.3 N after applying the traditional method of flexion-extension gap balance performed by an experienced expert.

This in vitro study was performed on a 60-year-old female cadaver. With the S-size femoral prosthesis and 3 mm bearing the target, after performing femoral grinding and tibial osteotomy, the surgeon used the gap gauge to assess flexion-extension gap tension preliminarily and believed that balance was achieved.
After the femoral trial was installed, the wireless sensor was inserted into the medial joint space, and the intra-articular pressure was measured three times at 110&#176; (flex...

Watch this Scientific Journal Video about In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty at JoVE.com

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

This protocol presents a cadaveric study of a wireless sensor used in medial unicompartmental knee arthroplasty. The protocol includes the installation of an angle measuring device, standardized Oxford unicompartmental knee arthroplasty osteotomy, preliminary assessment of flexion-extension balance, and application of the sensor to measure flexion-extension gap pressure.

In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty

Unicompartmental knee arthroplasty (UKA) is an effective treatment for end-stage anteromedial osteoarthritis (AMOA). The key to UKA is the ...

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