Surgical Techniques for Total Knee Arthroplasty: Measured Resection, Gap Balancing, and Hybrid

Total knee arthroplasty (TKA) is effective in managing end-stage degenerative joint disease. Achieving favorable clinical outcomes is predicated on proper implant alignment, sizing, and rotation as well as adequate soft-tissue balancing. Modern TKA implants are designed to address the fundamental needs of attaining stability in both flexion and extension and of optimizing patellar tracking. Measured resection and gap balancing are the two different techniques used to implant the TKA components used today. Both techniques have been validated as durable and successful, and each has unique advantages and disadvantages. A hybrid technique has been developed that combines the benefits of measured resection and gap balancing and minimizes the limitations associated with both techniques. This hybrid approach has the potential for achieving improved TKA kinematics and refined surgical technique.