Tibial Cut First Flexion Spacing Method for Mobile Total Knee Arthroplasty

Mobile bearing tibial prosthetics have become an attractive solution for dealing with tibial component malpositioning and long-term wear problems associated with total knee arthroplasty. This title demonstrates a contemporary flexion space tensor designed for ligament balancing. It provides details of the flexion spacing method.

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This title focuses on such areas as: joint replacement and hip, knee and lower extremity. Mobile bearing tibial prosthetics have become an attractive solution for dealing with tibial component malpositioning and long-term wear problems associated with total knee arthroplasty. Because of the increased degree of freedom of the implant, bearing-related complications have mandated a careful and accurate ligament balancing that has a limit of three to four millimeters laxity throughout the range of motion. Insall pioneered the flexion-based technique, which used ligament tension to determine the anterior and posterior cuts of the distal femur. Insall also stated that ligament balancing must be done with the knee in extension prior to making cuts that will create the flexion space. Numerous methods have been developed to try to accomplish this goal. In this video, Dr. Stiehl demonstrates a contemporary flexion space tensor designed for ligament balancing. The video provides details of the flexion spacing method, such as placing the saw to avoid ligaments and neurovascular structures, adjusting the anterior cortical cut and flexion space size, and determining the final extension space. Tips for the correct rotational placement of the implant, completing placement trials, and the order of the final insertion of the implant are included. While watching the video, the viewer will learn the comprehensive details of this surgical technique that Dr. Stiehl has refined after years of experience. A rationale for the procedure is included in this step-by-step video demonstration.