Patient-specific instrumentation combined with a new tool fo
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The findings of the Study proved that the gap-balancing technique in total knee arthroplasty (TKA) with patient-specific instrumentation (PSI) and a new balancing system enhanced the knee function more than the measured resection technique.

A retrospective analysis of data from 150 patients who underwent TKA was conducted. In 80 patients (82 knees), the gap-balancing technique with PSI and the new balancing system was used, and the measured resection technique was used in 70 patients (70 knees). The results of the surgery, imaging, and knee function tests were compared.

Results:
--The gap-balancing technique assisted by PSI and the new balancing device was found to be feasible in all operated knees and reliable.

--In total, 150 patients of ages ranging from 52 to 78 years underwent TKA during the study period. The follow-up period ranged from 35 to 52 months (mean 45 months).

--Only 1 patient, who was included in the gap-balancing group, underwent a revision surgery at 2 years postoperatively due to infection. There were no differences in the incidence of anterior knee pain between the two groups.

--The mean flexion angle, KSS scores, and VAS scores did not significantly differ between the measured resection group and gap-balancing group at 12 weeks or 36 weeks postoperatively.

--The average joint line displacement was 1.3 ± 1.1 mm (range 0–3) proximally in the GB (gap-balancing) group and 1.2 ± 1.4 mm in the MR (measured-resection) group. No outliers more than 5 mm in either group were recorded.

--The mean leg axis deviation from the neutral mechanical axis was 1.8°±1.5° varus (range 0°–3°varus) versus the neutral mechanical axis in the GB group and 1.4°±1.2°(range 0°–3°)in the MR group. No outliers with more than 3° deviation in either group were recorded.

Finally, the gap-balancing procedure, when combined with the new balancing system and PSI, resulted in correct femoral part alignment and 3-year outcomes that are comparable to those of calculated resection. Surgeons who want to use PSI to perform the gap-balancing technique should consider the new balancing system.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02467-6
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