Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
The reversed gap technique produces anatomical alignment with less midflexion instability in total knee arthroplasty: a prospective randomized trial.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Mean distraction force applied in tension-controlled ligament-balanced total knee arthroplasty: A systematic review and meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Midflexion instability in total knee arthroplasty: a systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2021Pooled it
- No differences in functional and clinical outcomes after rehabilitation between modified kinematic and mechanical alignment in total knee arthroplasty: A randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Trial
- Non-hygroscopic ionogel-based humidity-insensitive iontronic sensor arrays for intra-articular pressure sensing.National science review · 2024Article
- Comparison of postoperative clinical outcomes and knee stability of cruciate-retaining total knee arthroplasty using the tibia-first gap navigation technique with a computer-aided system and measured-resection technique: A retrospective analysis of a propensity-matched cohort.Journal of experimental orthopaedics · 2024Article
- Effect of posteromedial vertical capsulotomy with medial collateral ligament liberation on intraoperative medial component gap mismatch between extension and mid-flexion during total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- [Cumulative sum control chart analysis of soft tissue balance in total knee replacement assisted by electronic pressure sensor].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2023Article
- The effect of restored medial knee anatomy in total knee arthroplasty with the flexion first balancer technique on mid-flexion laxity and functional outcome.BMC musculoskeletal disorders · 2021Article
- Current concepts in total knee arthroplasty : mechanical, kinematic, anatomical, and functional alignment.Bone & joint open · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeNo surgical technique is capable of controlling the stability of the joint in midflexion. The purpose of the present study was to present and evaluate a surgical technique that aims to reduce the need for soft-tissue release and optimize stability in midflexion.
methodsSixty knee joints were included in this prospective randomized study. Surgery was performed either according to a classical gap (GT) technique or using the reversed gap (RG) technique. In the RG, the femoral component was positioned parallel to the surgical transepicondylar axis using a preoperative MRI and a navigation system. The frontal alignment of the tibia was then selected to produce a symmetric flexion gap. Then, the frontal alignment of the femoral component was adjusted to produce a symmetric extension gap. Soft-tissue release was defined to be extensive if more than two steps or stabilizing structures were involved. Joint stability was measured at different flexion angles (-5° to 120°) using a gap tensioning device and the trial femoral implant.
resultsIn the GT group, 16 knee joints (53 %) showed an instability of more than 2 mm at 5°, 30° or 60°, compared with 8 knee joints (27 %) in the RG group (p = 0.035). The RG did not lead to a reduction in the number of soft-tissue releases, but they were less extensive.
conclusionRG reduced midflexion instability and the number of extensive soft-tissue releases. It may simplify the operation by reducing the extent of soft-tissue releases and avoid instability-related problems of knee arthroplasty. Nevertheless, it should only be performed under controlled conditions until long-term clinical data are available. LEVEL OF EVIDENCE: I.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.