2006 - UZ Leuven

ORTHOPEDIEBELLEMANS J.: Comment obtenir une amplitude de flexion maximumaprès une PTG. Maitresse Orthopédique, 2006; 153: 6-9.En dépit des récents progres réalisés dans le domaine del’arthroplastie totale de genou, la limitation de l’amplitude de flexionreste un sujet de frustration pour de nombreux chirurgiens du genouet de nombreux patients.La faute est généralement rejetée sur le kinésithérapeute, le patient,ou les ingénieurs qui ont conçu la prothèse. Mais l’expérience nous amontré que le plus souvent, la limitation de l’amplitude de flexionaprès une PTG tient à des facteurs liés à la technique opératoire..BELLEMANS J., D’HOOGHE P., VANDENNEUCKER H., VAN DAMME G.:Soft tissue balance in total knee arthroplasty. Clinical Orthopaedics andrelated research, 2006; 452: 49-52.The restoration of correct soft tissue tension is key to achieving asuccessful total knee arthroplasty. However, it remains unclearwhether the status achieved immediately after the operation willpersist over time. Some surgeons believe soft tissue stress relaxationoccurs and therefore the knee loosens somewhat after the procedure.It was the aim of this study to investigate this hypothesis. Weanalyzed 25 in vivo total knee implantations using contemporarycomputer navigation technology to assess and quantify perioperativesoft tissue relaxation. Mediolateral joint laxity and maximal passiveextension were analyzed immediately intraoperatively and 30 minuteslater under the same conditions. Stress relaxation occurred in allcases, leading to increased mediolateral laxity by an average of 1 mmon the medial and lateral sides. Maximal passive extension increasedby an average of 3 degrees . This data confirms the hypothesis theknee becomes looser in the early phase after total knee arthroplasty.BELLEMANS J., VANDENNEUCKER H., VICTOR J., VANLAUWE J.:Flexion contracture in total knee arthroplasty. Clinical Orthopaedics andRelated Research, 2006; 452: 78-82.49