ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2019
Proven accuracy for a new dynamic gap measurement in navigated TKA.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 24 citations in OpenAlex.
- Predictive pre-resection robotic ligament balancing in total knee arthroplasty is accurate across surgeons and patient factors.Journal of robotic surgery · 2026Article
- Intraoperative landmarking errors and their avoidance in robotic-assisted total knee arthroplasty using the VELYS system.Journal of experimental orthopaedics · 2026Review
- Analysis of posterolateral and anterolateral laxity in varus knees undergoing robotic assisted total knee arthroplasty.Journal of robotic surgery · 2026Article
- The transepicondylar axis or the posterior condylar axis: Which is the best reference for femoral component rotation in robotic-assisted total knee arthroplasty?Arthroplasty (London, England) · 2026Article
- Independent of the preoperative coronal deformity, adjusted mechanical alignment leads in a high percentage to non-anatomical tibial and femoral bone cuts.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Dynamic gap analysis of valgus knees shows large inter-individual variability of gaps.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Systematic alignments yield balanced knees without additional releases in only 11% of knee arthroplasties: a prospective study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Navigated, gap-balanced, adjusted mechanical alignment achieves alignment and balancing goals in a very high percentage but with partially non-anatomical resections.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Any technology assisting total knee arthroplasty (TKA) will fail without the correct 3D alignment and balancing target.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Digital TKA Alignment Training with a New Digital Simulation Tool (Knee-CAT) Improves Process Quality, Efficiency, and Confidence.Journal of personalized medicine · 2023Article
- A single type of varus knee does not exist: morphotyping and gap analysis in varus OA.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- How will digitalisation affect patient treatment in arthroplasty? Part I: Intraoperative aspects.Journal of orthopaedicsArticle
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeClinical outcome of TKA remains unsatisfactory in 20% of the cases. Navigation has added accuracy in terms of alignment, but has improved clinical outcome only in small series with gap-balanced techniques. Reason for that could be that conventional gap balanced TKA determines gaps in extension and 90° of flexion only. Furthermore, measurement is only static. Therefore, the accuracy of a new dynamic navigation software which allows gap assessment throughout the entire range of motion was tested. The purpose of this study was to investigate the accuracy and reliability of dynamic gap testing during gap-balanced TKA.
methodsIn two different centres, a total of 65 TKA procedures were performed in a tibia-first, gap-balanced technique using a new CAS software. At the same and at different time points of surgery, two different surgeons performed gap measurement to provide inter-observer reliability data and repeated gap measurement to provide intra-observer reliability data. These gap measurements were performed throughout the entire ROM under dynamic stress testing to detect maximum gap values.
resultsCAS surgery was able to produce correct coronal alignment in 96.4% of the cases (within 3° mechanical alignment). Both inter-observer and intra-observer reliabilities were excellent for gap values throughout the entire ROM. Inter-observer bias of deviation 0.05; 95% limits of agreement of - 2.1 to + 2.21 mm. Intra-observer bias of deviation 0.09; 95% limits of agreement of - 2.27 to + 2.44 mm.
conclusionsThis new CAS software in combination with the presented dynamic gap measurement provides accurate gap values and therefore facilitates balancing TKA. This technique works reproducibly for different surgeons and has proven robustness also for repeated measurements of any surgeon in this study.
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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.