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Related Experiment Video

Updated: Jun 19, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
09:31

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

Gap balancing versus measured resection technique for total knee arthroplasty.

Douglas A Dennis1, Richard D Komistek, Raymond H Kim

  • 1Center for Musculoskeletal Research, University of Tennessee, Knoxville, TN, USA. kslutzky@co-ortho.com

Clinical Orthopaedics and Related Research
|October 1, 2009
PubMed
Summary

Gap balancing techniques in total knee arthroplasty (TKA) offer superior coronal stability compared to measured resection. This surgical approach minimizes femoral condylar lift-off, potentially improving patient outcomes and implant longevity.

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Area of Science:

  • Orthopedic Surgery
  • Biomechanical Engineering
  • Medical Imaging

Background:

  • Total knee arthroplasty (TKA) involves various surgical techniques.
  • Coronal plane stability is crucial for TKA success.
  • Femoral condylar lift-off is a key indicator of coronal instability.

Purpose of the Study:

  • To compare the coronal stability of TKA using measured resection versus gap balancing techniques.
  • To assess the incidence and magnitude of femoral condylar lift-off between techniques.
  • To determine if operative technique influences TKA stability.

Main Methods:

  • Retrospective analysis of 60 total knee arthroplasties (40 measured resection, 20 gap balancing).
  • Fluoroscopic analysis during deep knee bend to assess femoral condylar lift-off.

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Last Updated: Jun 19, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty
09:31

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

  • 3-D model fitting technique used to quantify lift-off incidence and magnitude.

    • Main Results:

    • Gap balancing showed significantly lower incidence of lift-off (>0.75 mm: 35%) compared to measured resection (PCL-retaining: 80%, PCL-substituting: 70%).
    • No lift-off >1 mm occurred in the gap balancing group, versus 60% and 45% in measured resection groups.
    • Measured resection techniques exhibited higher maximum lift-off magnitudes.

    Conclusions:

    • Gap balancing technique provides superior coronal stability in TKA.
    • Improved stability may lead to enhanced functional performance and reduced polyethylene wear.
    • Femoral component rotation in gap balancing is key to achieving better coronal alignment.