Soft-tissue balancing in primary total knee arthroplasty

The surgical goal of primary total knee arthroplasty (TKA) is to provide a well-balanced soft-tissue envelope surrounding a well-aligned, well-fixed implant. Some knee surgeons have emphasized that a good outcome in primary TKA is more dependent on soft-tissue management than bone management. Thus, it is imperative that the surgeon is familiar with knee soft-tissue balancing techniques to address the varus, valgus, and associated flexion contracture deformities commonly encountered in primary TKA.