Soft Tissue Balancing in Total Knee Arthroplasty

Abstract

This essay has discussed soft tissue balance in total knee arthroplasty including the following :

1- Soft tissue balance in the normal knee, which is an important factor in stability of the knee and depends on:

i- Extra- articular structures as:

• The Capsule, which is attached to the tibia and femur just beyond their articular margins, it is partly deficient and partly augmented by expansions from adjacent tendons.•

• Tibial collateral ligament: Long strong ligament provides stability against valgus stress.

• Fibulcollateral ligament: provides stability against varus stress.

• Musculotendinous structures: as the quadriceps muscle which includes the most important vastus medialis obliqus that prevents lateral dislocation of the patella in flexion, biceps femoris muscle which provides stability against varus stress and popliteus muscle which provides rotary stability to the femur on the tibia

ii- Intra - articular structures as:

• The menisci: medial and lateral menisci which are rotary stabilizers and essential for smooth transmission from a pure hinge to a gliding or rotary motion as the knee moves from flexion to extension.