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Gap-Balancing versus Measured Resection Technique in Total Knee Arthroplasty: A Comparison Study
Jessica L Churchill1, Anton Khlopas2, Assem A Sultan1
1Department of Orthopedics, Cleveland Clinic, Cleveland, Ohio.
The Journal of Knee Surgery
|November 28, 2017
Summary
Both measured resection and gap balancing techniques for total knee arthroplasty (TKA) show excellent implant survivorship and patient outcomes. This study found no significant differences in range of motion or function scores between the two TKA alignment methods.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Accurate femoral component alignment in total knee arthroplasty (TKA) is crucial for successful outcomes.
- Two primary techniques, measured resection and gap balancing, are used for axial plane alignment, with ongoing debate regarding their comparative efficacy.
Purpose of the Study:
- To compare implant survivorship, patient outcomes, complications, and radiographic results between measured resection and gap balancing techniques in TKA.
- To evaluate the accuracy and effectiveness of these two femoral alignment methods.
Main Methods:
- A comparative study of 221 primary TKAs performed between 2011-2012, utilizing measured resection (116 knees) or gap balancing (105 knees).
- Assessment included implant survivorship (Kaplan-Meier analysis), patient range-of-motion (ROM), Knee Society (KS) function and pain scores, and radiographic analysis.
- Data collected preoperatively and at multiple postoperative intervals up to 3 years.
Main Results:
- Aseptic survivorship was high and comparable at 98% for both groups.
- No significant differences were observed in mean ROM (123 degrees), KS function scores (86 vs. 85), or KS pain scores (93 vs. 92) between the measured resection and gap balancing groups.
- Radiographic evaluation revealed no progressive radiolucencies or loosening in either group at the latest follow-up.
Conclusions:
- Both measured resection and gap balancing techniques achieve excellent short-term survivorship and comparable postoperative outcomes in TKA.
- Accurate femoral component alignment can be reliably achieved using either method, suggesting flexibility in surgical approach based on surgeon preference and patient factors.
