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The Journal of Bone and Joint Surgery (American) 85:S38-S42 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Soft-Tissue Balance in Revision Total Knee Arthroplasty

Michael D. Ries, MD, Steven B. Haas, MD and Russell E. Windsor, MD

Corresponding author: Michael D. Ries, MDDepartment of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Avenue (MU 320-W), San Francisco, CA 94143. E-mail address: riesm@orthosurg.ucsf.edu

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

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   Introduction
 
Medial-lateral and flexion-extension soft-tissue balance are important components of a successful revision total knee arthroplasty. Symmetric medial and lateral collateral ligament tension in both flexion and extension as well as equal sizes of the flexion and extension gaps should be achieved prior to implantation of the final components. Medial-lateral soft-tissue tension and flexion-extension gap sizes are related but not identical issues.

Medial-lateral soft-tissue balancing requires release of contracted medial or lateral ligaments and tendons or, alternatively, advancement and reconstruction of lax ligaments. Flexion-extension balancing may involve release of contracted posterior soft tissue but also is affected by variation in the size and position of the implants. If adequate medial-lateral and flexion-extension stability cannot be achieved, use of a constrained implant is appropriate.


   Medial-Lateral Soft-Tissue Balancing
 
Assessment of the ligamentous status of the knee prior to primary or revision total knee arthroplasty should include a clinical evaluation of the patient's gait and standing alignment. . . . [Full Text of this Article]


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M. D. Ries, S. B. Haas, and R. E. Windsor
Soft-Tissue Balance in Revision Total Knee Arthroplasty. Surgical Technique
J. Bone Joint Surg. Am., March 1, 2004; 86(90001): 81 - 86.
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