title: Perfect balance in total knee arthroplasty: the elusive compromise.
abstract: A Tensor/Balancer device (Stryker Howmedica Osteonics, Allendale, NJ) was used to restore optimal stability and alignment during 83 consecutive total knee arthroplasties with a minimum of 6-week clinical and radiographic follow-up. The surgical technique is described. Mean flexion-extension symmetry was restored to within 1 degrees. Mean femoral rotation required to achieve symmetry in flexion differed between varus (4.38 degrees ) and valgus (6.0 degrees ) knees. Of 83 knees, 7 had >3 mm of subjective laxity during component trialing and were associated with a preoperative deformity of >15 degrees; 19 knees required femoral rotation of >6 degrees and were associated with greater preoperative malalignment. Postoperative knee alignment, range of motion, Knee Society score, and lateral release rate were similar between the 2 groups. The use of a Tensor/Balancer device in total knee arthroplasty can achieve outcomes comparable to existing techniques with potential for improved technical accuracy.
authors.affiliation: Hamilton Arthroplasty Group, Hamilton Health Sciences, Henderson General Hospital, and Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: M J
authors.initials: MJ
authors.lastname: Winemaker
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D016916:Joint Deformities, Acquired / Q000517:prevention & control; D007719:Knee Joint / Q000473:pathology* / Q000503:physiopathology*; D008023:Ligaments, Articular / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012399:Rotation