ArticleEFORT open reviews2018
What is a balanced knee replacement?
Article in EFORT open reviews, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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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
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A comparison on the clinical outcomes of using intraoperative load sensors versus manual balancing in total knee arthroplasty: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2025Pooled it
- Medial joint opening on immediate postoperative supine radiographs predicts inferior midterm functional outcomes in women after total knee arthroplasty.Musculoskeletal surgery · 2026Article
- Robotic-assisted total knee arthroplasty is associated with more favorable early patient-reported outcomes and may attenuate experience-related outcome differences.Journal of robotic surgery · 2026Article
- Full-flexion gap balancing-driven personalized preoperative planning for TKA: biomechanical evidence of improved load symmetry in an in vitro model.Arthroplasty (London, England) · 2026Article
- Comparison of the Reliability and Gap Differences Between Using the Varus-Valgus Stress Technique and Paddles Technique in Pre-Resection Balancing Phase of Robotic-Assisted Total Knee Arthroplasty.Arthroplasty today · 2026Article
- Validation of imageless navigation in total knee arthroplasty using a postoperative radiographic approach.Bulletin of the Hospital for Joint Disease (2013) · 2025Article
- From empirical to analytical: Soft-tissue tension gauging in total knee arthroplasty.Knee surgery & related research · 2025Review
- How reliable are surgeons at assessing soft-tissue laxities in robotic arm-assisted total knee arthroplasty? : a prospective, multicentre surgeon-blinded study.Bone & joint open · 2025Article
- Standardizing definitions of the total knee alignment techniques: recommendations by the Personalized Arthroplasty Society.EFORT open reviews · 2025Review
- Robotic evaluation of articular laxity (REAL) classification: a new intraoperative knee soft-tissue laxity classification using ROSA robotic software.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- A new gap balancing technique with functional alignment in total knee arthroplasty using the MAKO robotic arm system: a preliminary study.BMC surgery · 2024Article
- Intra-operative laxity and balance impact 2-year pain outcomes in TKA: a prospective cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Using sequential bone cutting to titrate soft tissue balance in total knee arthroplasty effectively minimizes soft tissue release.BMC musculoskeletal disorders · 2023Article
- Thicker polyethylene inserts (≥ 13 mm) increase the risk for early failure after primary cruciate-retaining total knee arthroplasty (TKA): a single-centre study of 7643 TKAs.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
- The learning curve associated with imageless navigation in total knee arthroplasty.Archives of orthopaedic and trauma surgery · 2023Article
- Total Knee Arthroplasty and Intra-Articular Pressure Sensors: Can They Assist Surgeons with Intra-Operative Decisions?Current reviews in musculoskeletal medicine · 2021Review
- Kinetic Sensors for Ligament Balance and Kinematic Evaluation in Anatomic Bi-Cruciate Stabilized Total Knee Arthroplasty.Sensors (Basel, Switzerland) · 2021Article
- Small soft tissue tension changes do not affect patient-reported outcomes one year after primary TKA.International orthopaedics · 2021Article
- Individualized surgery in primary total knee arthroplasty.EFORT open reviews · 2020Review
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
For multifactorial reasons an estimated 20% of patients remain unsatisfied after total knee arthroplasty (TKA).Appropriate tension of the soft tissue envelope encompassing the knee is important in total knee arthroplasty and soft tissue imbalance contributes to several of the foremost reasons for revision TKA, including instability, stiffness and aseptic loosening.There is debate in the literature surrounding the optimum way to achieve balancing of a total knee arthroplasty and there is also a lack of an accepted definition of what a balanced knee replacement is.It may be intuitive to use the native knee as a model for balancing; however, there are many difficulties with translating this into a successful prosthesis.One of the foundations of TKA, as described by Insall, was that although the native knee has more weight transmitted through the medial compartment this was to be avoided in a TKA as it would lead to uneven wear and early failure. There is a focus on achieving symmetrical tension and pressure and subsequent 'balance' in TKA, but the evidence from cadaveric studies is that the native knee is not symmetrically balanced.As we are currently trying to design an implant that is not based on its anatomical counterpart, is it possible to create a truly balanced prosthesis or to even to define what that balance is? The authors have reviewed the current evidence surrounding TKA balancing and its relationship with the native knee. Cite this article:
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