The reliability of sensor-assisted soft tissue measurements in primary total knee arthroplasty

Background: In pursuit to improve soft tissue balancing in total knee arthroplasties (TKAs), a wireless device was introduced to assess femorotibial pressures. The aim of this study was to evaluate the reliability of this device.

Methods: After 33 TKAs were balanced by conventional techniques, contact pressures were measured using a wireless sensor 3 times in a row; twice while the examiner was blinded for the result (n = 29); and once while the examiner was able to see the result as visual feedback (n = 32). Femorotibial pressures were measured in the medial and lateral compartments with the knee in 10°, 45°, and 90° of flexion (6 measurements per TKA). Furthermore, both the combined pressure and the difference in pressure between the compartments was calculated throughout the 3 positions (together another 6 measurements per TKA).

Results: The intraclass correlation coefficient between the blind measurements was poor in 2 of the 12 (17%), moderate in 4 of 12 (33%), and good in 6 of 12 (50%) measurements. The intraclass correlation coefficient between the blind and observing measurement was poor in 2 of the 12 (17%), moderate in 6 of 12 (50%), and good in 4 of 12 (33%) measurements. Especially measurements in 10° of flexion are associated with poorer reliability.

Conclusion: The wireless sensor has a moderate to good reliability in 83% of the measurements.