Clinical and Radiographic Outcome of Gap Balancing Versus Measured Resection Techniques in Total Knee Arthroplasty

Eva De Wachter; Johan Vanlauwe; Robert Krause; Hans Bayer-Helms; Dirk Ganzer; Thierry Scheerlinck

doi:10.1016/j.artd.2020.07.046

Clinical and Radiographic Outcome of Gap Balancing Versus Measured Resection Techniques in Total Knee Arthroplasty

Arthroplast Today. 2020 Oct 5;6(4):835-844. doi: 10.1016/j.artd.2020.07.046. eCollection 2020 Dec.

Authors

Eva De Wachter¹, Johan Vanlauwe¹, Robert Krause², Hans Bayer-Helms³, Dirk Ganzer⁴, Thierry Scheerlinck¹

Affiliations

¹ Department of Orthopedic Surgery and Traumatology, UZ Brussel, Brussels, Belgium.
² Department of Orthopedic Surgery and Traumatology, Oberlinklinik, Potsdam, Germany.
³ Department of Orthopedic Surgery and Traumatology, Hilden, Germany.
⁴ Department of Orthopedic Surgery and Traumatology, Dietrich-Bonhoeffer-Klinikum, Altentreptow, Germany.

Abstract

Background: There is no consensus regarding superiority between gap balancing (GB) and measured resection (MR) techniques to implant total knee arthroplasties. In a multicenter setup, we compared both techniques using the same prosthesis.

Methods: We included 262 balanSys posterior-stabilized total knee arthroplasties from 4 centers: 3 using the MR (n = 162) and one using the GB technique (n = 100), without navigation.

Results: There was no significant difference in the Knee Society Score or visual analog scale pain at 2- and 7-year follow-up. The visual analog scale for satisfaction was significantly better in the MR group at 2 but not at 7 years. We found a significantly higher average valgus in the GB group, but the overall alignment was within 2° of neutral on the full-leg radiographs. There were no significant differences concerning radiolucency and survival.

Conclusions: We found no significant differences in the functional outcome, pain, alignment, or survival, but a tendency toward better function using MR and better survival with GB.

Keywords: Arthroplasty; Gap balancing; Knee Society Score; Measured resection; Survival; TKA.