Clinical and Radiographic Outcome of Gap Balancing Versus Measured Resection Techniques in Total Knee Arthroplasty

Background There is no consensus regarding superiority between gap balancing (GB) and measured resection (MR) techniques to implant total knee arthroplasties. In a multicenter setup, we compared both techniques using the same prosthesis. Methods We included 262 balanSys posterior-stabilized total knee arthroplasties from 4 centers: 3 using the MR (n = 162) and one using the GB technique (n = 100), without navigation. Results There was no significant difference in the Knee Society Score or visual analog scale pain at 2- and 7-year follow-up. The visual analog scale for satisfaction was significantly better in the MR group at 2 but not at 7 years. We found a significantly higher average valgus in the GB group, but the overall alignment was within 2° of neutral on the full-leg radiographs. There were no significant differences concerning radiolucency and survival. Conclusions We found no significant differences in the functional outcome, pain, alignment, or survival, but a tendency toward better function using MR and better survival with GB.