ArticleJournal of orthopaedic surgery and research2021
Accuracy of soft tissue balancing in total knee arthroplasty using surgeon-defined assessment versus a gap-balancer or electronic sensor.
Article in Journal of orthopaedic surgery and research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Precision soft tissue balance in robot-assisted total knee arthroplasty: a bibliometric and visualization analysis of dynamic gap equilibration.Journal of robotic surgery · 2026Pooled it
- 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
- Real-time soft tissue balance assessment in total knee arthroplasty using a wireless flexible sensor array.Medical & biological engineering & computing · 2026Article
- Sensor-guided robot-assisted TKA more precisely achieves targeted functional knee phenotypes than conventional robotic-assisted technique.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026Article
- Comparative analysis of HURWA versus MAKO robotic-assisted TKA: a prospective cohort study of surgical accuracy and clinical outcomes.Journal of robotic surgery · 2026Article
- From empirical to analytical: Soft-tissue tension gauging in total knee arthroplasty.Knee surgery & related research · 2025Review
- Functional preoperative assessment of coronal knee laxity better predicts postoperative patient outcomes than intraoperative surgeon-defined laxity in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- [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
- Can mobile-bearing unicompartmental knee arthroplasty achieve natural gap-balancing? An observational study with a novel pressure sensor.Journal of orthopaedic surgery and research · 2022Observational
- Smart sensor implant technology in total knee arthroplasty.Journal of clinical orthopaedics and trauma · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundSoft tissue balancing is essential for the success of total knee arthroplasty (TKA) and is mainly dependent on surgeon-defined assessment (SDA) or a gap-balancer (GB). However, an electronic sensor has been developed to objectively measure the gap pressure. This study aimed to evaluate the accuracy of soft tissue balancing using SDA and GB compared with a sensor.
methodsForty-eight patients undergoing TKA (60 knees) were prospectively enrolled. Soft tissue balancing was sequentially performed using SDA, a GB, and an electronic sensor. We compared the SDA, GB, and sensor data to calculate the sensitivity, specificity, and accuracy at 0°, 45°, 90°, and 120° flexion. Cumulative summation (CUSUM) analysis was performed to assess the surgeon's performance during the sensor introductory phase.
resultsThe sensitivity of SDA was 63.3%, 68.3%, 80.0%, and 80.0% at 0°, 45°, 90°, and 120°, respectively. The accuracy of the GB compared with sensor data was 76.7% and 71.7% at 0° and 90°, respectively. Cohen's kappa coefficient for the accuracy of the GB was 0.406 at 0° (moderate agreement) and 0.227 at 90° (fair agreement). The CUSUM 0° line achieved good prior performance at case 45, CUSUM 90° and 120° showed a trend toward good prior performance, while CUSUM 45° reached poor prior performance at case 8.
conclusionSDA was a poor predictor of knee balance. GB improved the accuracy of soft tissue balancing, but was still less accurate than the sensor, particularly for unbalanced knees. SDA improved with ongoing use of the sensor, except at 45° flexion.
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