ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Dynamic gap analysis of valgus knees shows large inter-individual variability of gaps.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Intraoperative landmarking errors and their avoidance in robotic-assisted total knee arthroplasty using the VELYS system.Journal of experimental orthopaedics · 2026Review
- Coronal plane alignment of the knee classification system does not reliably predict tibiofemoral joint gaps in arthritic knees undergoing total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- 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
- [New technologies in total knee arthroplasty : Current concepts and personalized treatment strategies].Orthopadie (Heidelberg, Germany) · 2025Review
- Soft tissue laxity is highly variable in patients undergoing total knee arthroplasty.Arthroplasty (London, England) · 2024Article
- 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
- Digital TKA Alignment Training with a New Digital Simulation Tool (Knee-CAT) Improves Process Quality, Efficiency, and Confidence.Journal of personalized medicine · 2023Article
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Authors and funding
3 authors.
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Abstract
purposeThe purpose of this study was to investigate the dynamic gap widths of valgus knees in extension and flexion to evaluate the influence of deformity on gap differences and to find out whether different ligamentous subtypes in valgus knees exist.
methodsDynamic gap widths of 1000 consecutive total knee arthroplasty (TKA) patients were measured at different flexion angles by applying a computer-assisted surgery (CAS) technique. 198 knees showed a valgus deformity and were assessed regarding its degree of fulfillment of the following criteria of valgus knee: 1. Medial extension gap greater than lateral; 2. Medial flexion gap greater than lateral; 3. Flexion gap greater than extension gap. A single-factor ANOVA subgroup analysis was performed, based on the amount of deformity. The effect of other patient factors (age, gender, weight) on gap differences was investigated.
resultsThe medial extension gap (3.7 ± 2.2 mm) was significantly (p < 0.01) larger than the lateral extension gap (1.1 ± 2.9 mm). The amount of deformity correlated highly with gap difference in extension (r
conclusionValgus knees show large variability in terms of gap widths. The extent of deformity correlates highly with gap difference in extension, but not in other flexion angles. Vast majority of valgus knees were valgus in extension only. Because of this variability, it should be aimed for an individualized balancing technique based on intraoperative gap sizes. LEVEL OF EVIDENCE: Level III.
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