The Way To Predict The Range Of Medial Soft Tissue Realease In Total Knee Arthroplasty

Objective:To explore the way to predict whether the surgeons need to release the superficial Medial Collateral Ligament(sMCL) when they deal with the osteoarthritis patients with varus deformity by imaging in total knee arthroplasty(TKA).Methods:1.Get knee imagings(MRI and X-ray) of 23 patients(27 varus knees) with OA.2.Measure the length of sMCL,the angle of knee varus,the length of medial osteophyte,and other related values.3. Simulate the modified angle after removing the medial osteophyte and tensing the sMCL by software,then predict whether the surgeons need to release sMCL by comparing the modified angle with the varus angle of knee.4.Check the predicting consequence by operation.5. Count the reliability of the results by statistical methods.Results:The correlation between the modified angle and the the tension degree of sMCL is 0.99725; The correlation between the the tension degree of sMCL and the relative length of the osteophyte is 0.43493; The correlation between the the tension degree of sMCL and the varus angle in X-ray is 0.38929; The correlation between the length of the osteophyte and the varus angle in X-ray is 0.55135; The correlation between the relative length of the osteophyte and the varus angle in X-ray is 0.55922; The correlation between the modified angle and the relative length of the osteophyte is 0.42459; The concordance rate between predicted results by the tension degree of sMCL and actual results is 29.6%(8/27); The average relative length of the osteophyte in released group is 0.060939944, The average relative length of the osteophyte in non-released group is 0.085741934, the difference is statistically significant (P= 0.030 <0.05);The release rate of Group A (R<0.060939944) was 42.9%, Group B (0.060939944(?)R<0.085741934) was 10.0%, Group C (R> 0.085741934) was 0.0%.The differences of the release rate among the three groups were statistically significant.Conclusions:â‘ Whether the sMCL should be released can not be well predicted by the tension degree of sMCL in MRI.â‘¡hether the sMCL should be released can be well predicted by the relative length of the osteophyte in X-ray; The release of the sMCL is not generally needed if the relative length of the osteophyte R>0.085741934; The release of the sMCL is generally needed if R<0.060939944; The release of the sMCL maybe be needed if 0.060939944