title: The use of navigation to achieve soft tissue balance in total knee arthroplasty - a randomised clinical study.
abstract: BACKGROUND
  Achieving soft tissue balance is an operative goal in total knee arthroplasty. This randomised, prospective study compared computer navigation to conventional techniques in achieving soft tissue balance.
  
  
  METHODS
  Forty one consecutive knee arthroplasties were randomised to either a non-navigated or navigated group. In the non-navigated group, balancing was carried out using surgeon judgement. In the navigated group, balancing was carried out using navigation software. In both groups, the navigation software was used as a measuring tool.
  
  
  RESULTS
  Balancing of the mediolateral extension gap was superior in the navigation group (p=0.001). No significant difference was found between the two groups in balancing the mediolateral flexion gap or in achieving equal flexion and extension gaps.
  
  
  CONCLUSIONS
  Computer navigation offered little advantage over experienced surgeon judgement in achieving soft tissue balance in knee replacement. However, the method employed in the navigated group did provide a reproducible and objective assessment of flexion and extension gaps and may therefore benefit surgeons in training.
  
  
  METHODS
  Level I, RCT.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Joseph
authors.forename: P M S
authors.initials: PM
authors.lastname: Simpson
authors.forename: S L
authors.initials: SL
authors.lastname: Whitehouse
authors.forename: H W
authors.initials: HW
authors.lastname: English
authors.forename: W J
authors.initials: WJ
authors.lastname: Donnelly
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000503:physiopathology; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011793:Queensland; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D017695:Soft Tissue Injuries / Q000517:prevention & control; D018709:Statistics, Nonparametric; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Arthroplasty; Navigation; Surgery; Tissue balance; Total knee replacement