2017 ISAKOS Biennial Congress ePoster #1255

 

Comparison Of Gap Balancing Versus Measured Resection Technique In Bilateral Simultaneous Total Knee Replacement.

Sachin Ramchandra Tapasvi, MBBS, MS, DNB, FRCS, Pune, Maharashtra INDIA
Anshu Shekhar, MS, Pune, Maharashtra INDIA
Shantanu S. Patil, MBBS, MS(Orth), Kattankulathur, Tamilnadu INDIA

The Orthopaedic Speciality Clinic, Pune, Maharashtra, INDIA

FDA Status Cleared

Summary

This is a randomized prospective study of the comparison between measured resection and gap balancing technique.

Abstract

Introduction

There are two principal ways of performing total knee arthroplasty; Measured resection and Gap balancing . While multiple studies have compared the results of one technique over the other, there are no reports on comparison of the two techniques performed on the same patient undergoing bilateral surgery.

Method

35 patients (28:7 F:M; mean age 66 ± 8.3 years , range 51-89) with diagnosed bilateral osteoarthritis of knee, with similar degrees of varus or valgus undergoing surgery were included after institutional review and informed consent. All patients underwent bilateral simultaneous total knee replacement. Baseline outcome data were collected using the IKDC, KOOS and Oxford Knee Scores. All cases were operated by a single joint replacement surgeon at a tertiary Center. Post operatively, all patients underwent a standardized rehabilitation protocol that was altered as necessary.
The surgeon chose either measured resection technique or the gap balancing technique on either knee as per a randomization chart. The goal was to achieve a stable balanced knee joint.
The thickness of each resected bone cut was collected and measured using digital calipers. Intra operative flexion and extension gaps were measured. Mid flexion instability, if any were recorded and addressed.

Results

More bone was resected from distal femur as well as posterior femur while using gap balancing technique as compared to measured resection. However on the tibial side, more bone was excised in measured resection technique. The differences between the measured extension gap and flexion gap after the bone cuts using either technique was not statistically significant.

Discussion

This is a randomized prospective study of the comparison between measured resection and gap balancing technique. Though clinically the patients do not report any difference in their operated knees, more bone is resected on an average with the gap balancing technique.