Caution Required When Using an Intraoperative Knee Balancer in Total Knee Arthroplasty

Does a Modified Gap-balancing Technique Result in Medial-pivot Knee Kinematics in Cruciate-retaining Total Knee Arthroplasty?: A Pilot Study

“…Using spacer blocks, the extension gap was balanced, and medial ligament releases performed if necessary. In 90°of flexion, using anterior referencing, a double-piston tensiometer [12] with a distraction force of 90 N was inserted. We followed the recommendation of Kesman et al [12] to rely on distraction distance rather than tension.…”

“…In 90°of flexion, using anterior referencing, a double-piston tensiometer [12] with a distraction force of 90 N was inserted. We followed the recommendation of Kesman et al [12] to rely on distraction distance rather than tension. Posterior resection was based on tensiometer metric scale to match extension gap, and tight PCL portions in flexion were routinely released to match extension gap [11].…”

“…Femoral rotation was measured using a double tensiometer [12], which was inserted in 90°flexion. After distraction to 10 mm on the metric scale medially and 13 to 14 mm laterally, the posterior femoral component thickness of 8 mm was taken off the posterior medial condyle.…”

Capsular release around the intercondylar notch increases the extension gap in posterior-stabilized rotating-platform total knee arthroplasty

“…Recently, various knee-balancing devices have been developed to assist surgeons in balancing the flexion and extension spaces. A previous study demonstrated that the knee balancer, used in our study for clinical assessment, accurately measured distances [9]. Therefore, different results are obtained when different devices or distraction forces are applied.…”

“…Immediately following tibial osteotomy, the extension gap was measured while the patella was reversed using a knee balancer (DePuy Orthopedics Inc., Warsaw, IN, USA, Figure 1) [9]. This device assists surgeons in balancing the flexion and extension spaces during TKA.…”