Evidence map›Paper›PMID 40235413›Full record

Trial reportJoint diseases and related surgery2025

Does the gap balance technique really elevate the joint line in total knee arthroplasty? A single-center, randomized study.

Özgür Avci, Alpaslan Öztürk, Yavuz Akalın, Nazan Çevik, Ali Çınar, Hikmet Şahin

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Joint diseases and related surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. [Application of transverse tibial axis reference method in rotational positioning of femoral prosthesis in total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Özgür AvciÖzgür Avci, MD. Tavşanlı Devlet Hastanesi, Ortopedi ve Travmatoloji Kliniği, 43300 Tavşanlı, Kütahya, Türkiye. zgravc88@gmail.com.
Alpaslan Öztürk
Yavuz Akalın
Nazan Çevik
Ali Çınar
Hikmet Şahin

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aims to compare patients undergoing total knee arthroplasty (TKA) with gap balancing (GB) versus measured resection (MR) techniques in terms of joint line (JL) using radiographic measurements from both femoral and tibial sides. PATIENTS AND

methodsBetween August 2019 and May 2021, a total of 107 patients who underwent TKA were included in this randomized study. The patients were divided into two groups as the GB group (n=54; 9 males, 45 females; mean age: 66.6±7.4 years; range, 51 to 81 years) and the MR group (n=53; 10 males, 43 females; mean age: 64.0±6.8 years; range, 50 to 80 years). The adductor tubercle joint line (ATJL) and the tibial tubercle joint line (TTJL) were evaluated for JL measurement. Clinical and functional evaluation was made using the range of motion of the joint, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Knee Society Score (KSS)-Knee and Functional scores.

resultsThe mean follow-up was 34.2±3.5 months in the GB group and 34.4±3.3 months in the MR group (p=0.80). The mean operation time was 119.1±14.9 min in the GB group and 118.6±17.5 min in the MR group (p=0.89). A total of 31 (57.4%) patients in the GB group had a degree of release of 3-4, while 21 (39.6%) patients in the MR group had a degree of release of 3-4 (p=0.26). The ATJL measurement was similar in the GB and MR groups, while the TTJL measurement was significantly different between the two groups (p=0.01). There was no significant correlation between the ATJL measurement and the degree of release, while there was a significant correlation between the TTJL and the degree of release (r=0.731, p<0.001).

conclusionWhile ATJL measurements in TKA showed similar results with GB and MR techniques, the amount of release may have caused the significantly higher JL elevation in the GB group in TTJL measurements. Based on these findings, we suggest that radiographic JL measurements on both the tibial and femoral sides in TKA may provide a more accurate assessment and we recommend to measure JL from the femoral side.

Indexed as

Arthroplasty, Replacement, KneeKnee JointOsteoarthritis, KneeAgedAged, 80 and overFemaleFemurHumansMaleMiddle AgedRadiographyRange of Motion, ArticularTibiaTreatment Outcome

Identifiers

PMID40235413
PMCPMC12086496

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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.