Abstract
INTRODUCTION
The results of modified gap balancing and measured resection technique have been still controversial. We compared PS-type TKAs for osteoarthritis performed using the modified gap technique and the measured resection to determine if either technique provides superior clinical results.
METHODS
The modified gap technique was used in 85 knees, and the measured technique using preoperative CT was used in 70 knees. To compare intra-operative soft tissue balance, bone gap and component gap were measured using original two paddle tensor (20,30,40lb) at 0 degree extension and 90 degrees flexion. To assess the post-operative patella congruency and soft tissue balance, we measured patella tilt, condylar twist angle (CTA) and condylar lift-off angle (LOA) in radiographs. Finally, we evaluated postoperative clinical result (1–5 years) KOOS. Statistical analysis was used by StatView.
RESULTS
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(1)
Component gaps in flexion at measured techniques were bigger than at gap techniques. Lateral flexion-extension gap and lateral-medial balance at 30lb or 40lb in the measured technique were statistically bigger than the gap technique.
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(2)
There were no statistical correlations with patella tilt, CTA and LOA in both techniques. There were no significant differences between each of the two techniques.
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(3)
KOOS of ‘pain during going up or down stairs’ for the measured technique were statistically worse than for the gap technique.
DISCUSSION
Intra-operative lateral gap and flexion balance using measured technique were bigger than gap technique, but there were no statistical differences in post-operative LOA and PF congruency in radiographs. Post-operative pain on stairs might be affected by the differences in intra-operative gap and balance between the two techniques with the balanced ligament technique showing more positive results.
