title: Outcome in total knee arthroplasty with a medial-lateral balanced versus unbalanced gap.
abstract: To evaluate the clinical outcome in 108 total knee arthroplasty (TKA) patients with a medial-lateral balanced versus unbalanced gap after a mean follow-up of 34 months.
  
  
  
  64 women and 44 men (mean age, 69.5 years) underwent computer-assisted TKA for osteoarthritis using a cemented fixed-bearing cruciate-retaining prosthesis. The medial-lateral gap difference (measured with the prosthesis in situ and the patella reduced) was balanced (≤2 mm) in 81 patients and unbalanced (>2 mm) in 27 patients. After a mean follow-up of 34 months, patients were assessed using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire for pain, stiffness, and physical function. Scores were normalised to 0% (worst) to 100% (best).
  
  
  
  The balanced and unbalanced gap groups were comparable in terms of age, severity of osteoarthritis, and proportion of pre- and post-operative mechanical alignment. Compared with the balanced gap group, the unbalanced gap group had a larger medial-lateral extension gap difference (0.75±0.57 vs. 2.02±1.15 mm, p=0.001) and medial-lateral flexion gap difference (0.79±0.63 vs. 2.98±2.13 mm, p=0.001) and lower normalised total WOMAC score (84.9±18 vs. 74.8±20.8, p=0.017).
  
  
  
  WOMAC score is better in TKAs with a medial-lateral balanced (<2 mm) gap.
authors.affiliation: Orthopaedic and Trauma Surgery Center, University Medical Center Mannheim of University Heidelberg, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Jawhar
authors.forename: Karolin
authors.initials: K
authors.lastname: Hutter
authors.forename: Hanns-Peter
authors.initials: HP
authors.lastname: Scharf
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: arthroplasty, replacement, knee; surgery, computer-assisted