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Updated: Jul 14, 2026
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In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Load balance in total knee arthroplasty: an in vitro analysis
Ron El-Hawary1, Sandra E Roth, Graham J W King
1Division of Orthopaedic Surgery, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada. ron.el-hawary@iwk.nshealth.ca
Summary
Load balancing in total knee arthroplasty (TKA) is crucial for optimal outcomes. Real-time load cell guidance significantly improves knee compartment load balance compared to conventional methods.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Biomedical Engineering
Background:
- Total knee arthroplasty (TKA) aims to equalize medial and lateral compartment knee loads.
- Accurate load balancing is essential for successful TKA outcomes.
- Conventional TKA balancing methods are often qualitative and may be imperfect.
Purpose of the Study:
- To evaluate the effectiveness of an instrumented load cell in real-time for achieving knee compartment load balance during TKA.
- To compare load balancing outcomes with and without direct visualization of load cell data.
Main Methods:
- Ten cadaveric knees underwent TKA.
- Compartment forces were measured from 0-90 degrees flexion before and after load balancing.
- Knees were randomized into groups with or without surgeon visualization of the load cell output during balancing.
Main Results:
- Significant medial and lateral compartment load differences existed in all knees prior to balancing (p < 0.05).
- Using the load cell achieved equal load balance at all tested angles.
- Without load cell assistance, consistent balance was not achieved across all angles.
Conclusions:
- Conventional load balancing techniques in TKA demonstrate limitations.
- Real-time load cell guidance offers a more accurate and consistent method for achieving knee compartment load balance in TKA.