{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:09:40Z","timestamp":1792782580651,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,11,18]],"date-time":"2015-11-18T00:00:00Z","timestamp":1447804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,11,18]],"date-time":"2015-11-18T00:00:00Z","timestamp":1447804800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"Smith & Nephew"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Balancing unicondylar knee arthroplasty (UKA) is challenging. If not performed properly, it may lead to implant loosening or progression of osteoarthritis in the preserved compartment. This study was aimed to document the biomechanical effects of improper balancing. We hypothesised that overstuffing would lead to more valgus, higher strain in the medial collateral ligament (sMCL), and higher lateral contact force.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six fresh\u2010frozen cadaver specimens were mounted in a kinematic rig. Three motion patterns were applied with the native knee and following medial UKA (passive motion, open\u2010chain extension, and squatting), while infrared cameras recorded the trajectories of markers attached to femur and tibia. Three inlay thicknesses were tested (8, 9, 10\u00a0mm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overstuffed knees were in more valgus and showed less tibial rotation and higher strains in the sMCL (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Lateral contact forces were higher in some specimens and lower in others. Stiffening of the medial compartment by UKA, even well balanced, already leads to a knee more in valgus with a more stressed sMCL. Overstuffing increases these effects. Knees with a tight sMCL may even see lower lateral contact force. Biomechanics were closest to the native knee with understuffing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The first two hypotheses were confirmed, but not the latter. This underlines the importance of optimal balancing. Overstuffing should certainly be avoided. Although kinematics is only slightly affected, contact forces and ligament strains are considerably changed and this might be of more clinical importance. It is advisable to use thinner inlays, if stability is not compromised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00167-015-3848-5","type":"journal-article","created":{"date-parts":[[2015,11,18]],"date-time":"2015-11-18T06:26:13Z","timestamp":1447827973000},"page":"3218-3228","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Balancing UKA: overstuffing leads to high medial collateral ligament strains"],"prefix":"10.1002","volume":"24","author":[{"given":"Thomas J.","family":"Heyse","sequence":"first","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery University Hospital Marburg Baldingerstrasse 35043 Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal F.","family":"El\u2010Zayat","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery University Hospital Marburg Baldingerstrasse 35043 Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronny","family":"De Corte","sequence":"additional","affiliation":[{"name":"Smith &amp; Nephew Zaventem Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lennart","family":"Scheys","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Katholieke Universiteit Leuven Louvain Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Chevalier","sequence":"additional","affiliation":[{"name":"Klinikum Gro\u00dfhadern, Orthop\u00e4dische Klinik und Poliklinik Labor f\u00fcr Biomechanik und Experimentelle Orthop\u00e4die Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Fuchs\u2010Winkelmann","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery University Hospital Marburg Baldingerstrasse 35043 Marburg 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Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2008.06.013"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00748"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2002.34527"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010012\u20102157\u20105"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101449\u20105"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BLO.0b013e3181592589"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.04.012"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2013.06.006"},{"key":"e_1_2_7_10_1","doi-asserted-by":"crossref","unstructured":"DelportH LabeyL InnocentiB De CorteR Vander SlotenJ 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