Related Experiment Video
Updated: Mar 1, 2026
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
The Influence of Joint Distraction Force on the Soft-Tissue Balance Using Modified Gap-Balancing Technique in
Kanto Nagai1, Hirotsugu Muratsu2, Yoshiki Takeoka2
1Department of Orthopaedic Surgery, Steel Memorial Hirohata Hospital, Himeji, Japan; Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Background:
During modified gap-balancing technique, there is no consensus on the best method for obtaining appropriate soft-tissue balance and determining the femoral component rotation.
Methods:
Sixty-five varus osteoarthritic patients underwent primary posterior-stabilized total knee arthroplasty using modified gap-balancing technique. The influence of joint distraction force on the soft-tissue balance measurement during the modified gap-balancing technique was evaluated with Offset Repo-Tensor between the osteotomized surfaces at extension, and between femoral posterior condyles and tibial osteotomized surface at flexion of the knee before the resection of femoral posterior condyles. The joint center gap (millimeters) and varus ligament balance (°) were measured under 20, 40, and 60 pounds of joint distraction forces, and the differences in these values at extension and flexion (the value at flexion minus the value at extension) were also calculated.
Results:
The differences in joint center gap (-6.7, -6.8, and -6.9 mm for 20, 40, and 60 pounds, respectively) and varus ligament balance (3.5°, 3.8°, and 3.8°) at extension and flexion were not significantly different among different joint distraction forces, although the joint center gap and varus ligament balance significantly increased stepwise at extension and flexion as the joint distraction force increased.
Conclusion:
The difference in joint center gap and varus ligament balance at extension and flexion were consistent even among the different joint distraction forces. This novel index would be useful for the determination of femoral component rotation during the modified gap-balancing technique.
