Meta-analysis of gap balancingversusmeasured resection techniques in total knee arthroplasty

Abstract

This study suggests that GB may provide better radiographic and clinical outcomes than MR when used to determine mechanical rotation in TKAs. Cite this article: Bone Joint J 2017;99-B:151-8.

Comparison of Gap Balancing vs Measured Resection Technique in Patients Undergoing Simultaneous Bilateral Total Knee Arthroplasty: One Technique per Knee

“…Studies comparing the MR technique with the GB technique do discern technical differences in results; however, it is difficult to detect a consistent superiority of either technique utilizing functional outcome scores and/or revision rates [33e35]. The meta-analyses by both Moon and Huang found that both the techniques were comparable with respect to gap symmetry, except for a difference in medial and lateral extension gaps [36,37]. Matsumoto et al found that the balance was better achieved in cruciate-retaining TKA than in posterior substituting TKA with the GB technique and both were superior to the MR technique.…”

Gait Analysis 1 Year after Primary TKA: No Difference between Gap Balancing and Measured Resection Technique

“…Moreover, both techniques have drawbacks with potential consequences on the results; the measured resection relies on anatomic landmarks which are not accurate enough to make a 3-degree external rotation as standard, and gap balancing might result in exaggerated external rotation, 4 in addition to a raise in the joint line. 5 Nowadays, almost every implant allows for either a measured resection or a gap-balancing technique, illustrating a "symptomatic" dichotomy among orthopaedic surgeons to strive for better outcomes. Surgeries for this study were performed aiming at a straight mechanical alignment, with stability evaluated by assessing varus/valgus stability at 90 degree flexion and in full extension, rather than testing the full range of motion and all degrees of freedom (in particular anterior-posterior translation and rotation).…”

Total diz artroplastisinde dizilim, komponent boyut ve yerleşim sorunları

“…Bu iki yöntemi karşılaştıran güncel bir meta-analizin sonuçlarına göre; boşluk dengeleme yöntemi, ölçülü rezeksiyon yöntemine oranla mekanik ve rotasyonel dizilimin restorasyonunda, diz ve fonksiyon skorlarında anlamlı olarak daha belirgin iyileşmeler sağlarken; FK'de biraz daha fazla dış rotasyon eğilimine ve eklem seviyesinin daha fazla yükselmesine neden olmaktadır. [25] Ayrıca ,"boşluk dengeleme" yöntemiyle aşırı büyüklükte fleksiyon boşluğu oluşumu ve orta-fleksiyon instabilitesi riskleri de bildirilmiştir. Ölçülü rezeksiyon yöntemi de sık koronal instabiliteye ve medio-lateral asimetriye neden olabilmesi yüzünden eleştirilmektedir.…”