Clinical value of gap balance technique guided by computer-assisted navigation in total knee replacement: report of 63 cases

Objective To investigate the value of gap balance technique guided by computer-assisted navigation in total knee replacement. Methods A total of 63 patients with primary knee osteoarthritis and underwent total knee replacement from January to June 2018 were recruited in this study. They were randomly divided into experimental group (n=31, gap balance technique guided by computer-assisted navigation) and control group (n=31, osteotomy technique). The tension of medial and lateral ligaments in the flexion and extension space was recorded, and the limb alignment, incision length, operative time, blood loss volume, drainage volume, incidence of postoperative complications, and visual analogue scale (Vas) score and knee society knee score (KSS) in 1, 6 and 12 months after operation were recorded and compared between 2 groups. Results The operative time in experimental group was significantly longer than that in the control group (P < 0.05), but there were no significant differences in incision length, blood loss, drainage volume and incidence of postoperative complications between 2 groups (P>0.05). The limb alignment was better in the experimental group than the control group [(0.63±0.54)° vs (1.98±0.52)°, P < 0.05]. In 1 month after operation, the experimental group achieved significantly better Vas score (3.53±0.51 vs 4.24±0.49, P < 0.05), but similar KSS score (69.3±5.1 vs 67.5±3.7, P>0.05) when compared with the control group. But, in 6 and 12 months after surgery, no statistic differences were seen in the above 2 scores (P>0.05). For the patients from the experimental group, the tension of medial and lateral ligaments in the flexion and extension space ranged from 70 to 95 N, with an average of 84 N. Conclusion Gap balance technique guided by computer-assisted navigation can improve the accuracy of osteotomy in total knee replacement, with postoperative benefits of significantly reducing pain and rapid recovery during the early postoperative period, but having no obvious effect on outcome after 1 year's follow-up.