Posteromedial vertical capsulotomy selectively increases the extension gap in posterior stabilized total knee arthroplasty

Shin Masuda, Shinichi Miyazawa, Kodama Yuya, Yusuke Kamatski, Hino Tomohito, Okazaki Yoshiki, Okazaki Yuki, Takayuki Furumatsu, Toshifumi Ozaki

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Purpose: In total knee arthroplasty (TKA), it is important to obtain an appropriate flexion–extension gap. The extension gap is expanded by posteromedial vertical capsulotomy (PMVC). This study aimed to evaluate the increase in the extension gap by PMVC using a navigation system. Methods: In posterior stabilized (PS)-type TKA, PMVC was performed in 37 knees. The medial extension gap at 0° and flexion gap at 90° flexion of the knee joint using the navigation system before and after PMVC were measured. Results: The extension gap before the PMVC was 5.3 ± 2.9 mm. After PMVC, the extension gap had significantly increased to 8.0 ± 2.8 mm (p < 0.001). In addition, the flexion gap was 8.1 ± 2.7 mm before the PMVC, but it was 8.7 ± 2.8 mm after the PMVC, and the flexion gap was not enlarged (n.s.). Conclusion: In PS-type TKA, it is possible to obtain selective expansion of about 2.7 mm of the extension gap by PMVC. Therefore, gap balance can be acquired by soft-tissue treatment while preserving the bone. The PMVC was a useful method for acquiring gap balance and preserving the bone stock. Level of evidence: IV.

Original languageEnglish
Pages (from-to)1419-1424
Number of pages6
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number5
Publication statusPublished - May 1 2020


  • Extension gap
  • Flexion gap
  • Navigation system
  • PS
  • Posteromedial vertical capsulotomy
  • Total knee arthroplasty

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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