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The Journal of Bone and Joint Surgery (American) 85:132-135 (2003)
© 2003 The Journal of Bone and Joint Surgery, Inc.

Comparison of Ligament-Balancing Techniques During Total Knee Arthroplasty

William M. Mihalko, MD, PHD, Leo A. Whiteside, MD and Kenneth A. Krackow, MD

Corresponding author:
William M. Mihalko, MD, PhD
Orthopaedic Research Laboratory, 162K Farber Hall, 3435 Main Street,
University at Buffalo, Buffalo, NY 14214-3000. E-mail address:
mihalk@buffalo.edu

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Ligament-balancing techniques are utilized to balance the flexion and extension gaps of the knee during total knee arthroplasty. Many different techniques to test for ligament balancing (as well as different structural release techniques and sequences of structural release) have been reported1-9. Distraction testing methods include the use of tension jigs, laminar spreaders, and spacer blocks or in-line traction to assess the joint gap after the femoral and tibial bone cuts have been made. This concept was popularized by Freeman et al.1 and Insall et al.2 and involves distracting the joint space in both flexion and extension to balance the gaps created when the joint gap is filled with prosthetic components (Fig. 1). The change in the shape of the joint gap from flexion to extension has been termed "gap kinematics," and the goal is to balance these gaps during total knee arthroplasty4,5,7. Another technique for testing . . . [Full Text of this Article]


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