title: Gap balancing sacrifices joint-line maintenance to improve gap symmetry: a randomized controlled trial comparing gap balancing and measured resection.
abstract: A total knee arthroplasty can be completed using two techniques; measured resection or gap balancing. A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or gap balancing (n = 51). Primary outcome measure was femoral component rotation. Secondary outcome measures were joint-line change, gap symmetry and function and quality-of-life outcomes. Gap balancing resulted in a significantly raised joint-line compared to measured resection. Gap symmetry was significantly better using gap balancing. Functional outcomes and quality-of-life were not significantly different at 24 months. Using computer navigation, gap balancing significantly raises the joint-line in order to improve gap symmetry. This does not result in a clinical difference in function or quality of life at 24 months.
authors.affiliation: St. Vincent's Hospital (Melbourne), Department of Orthopaedics, Fitzroy, Victoria, Australia; University of Melbourne, Department of Surgery.
authors.forename: Sina
authors.initials: S
authors.lastname: Babazadeh
authors.affiliation: St. Vincent's Hospital (Melbourne), Department of Orthopaedics, Fitzroy, Victoria, Australia; University of Melbourne, Department of Surgery.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Dowsey
authors.affiliation: St. Vincent's Hospital (Melbourne), Department of Orthopaedics, Fitzroy, Victoria, Australia.
authors.forename: James D
authors.initials: JD
authors.lastname: Stoney
authors.affiliation: St. Vincent's Hospital (Melbourne), Department of Orthopaedics, Fitzroy, Victoria, Australia; University of Melbourne, Department of Surgery.
authors.forename: Peter F M
authors.initials: PF
authors.lastname: Choong
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012399:Rotation; D013977:Tibia / Q000601:surgery
keywords: arthroplasty; function; gap balancing; knee; measured resection