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The use of navigation to achieve soft tissue balance in total knee arthroplasty - A randomised clinical study.

Knee. 2013 Jul 26;

Authors: Joseph J, Simpson PM, Whitehouse SL, English HW, Donnelly WJ

Abstract
BACKGROUND: Achieving soft tissue balance is an operative goal in total knee arthroplasty. This randomised, prospective study compared computer navigation to conventional techniques in achieving soft tissue balance.
METHODS: Forty one consecutive knee arthroplasties were randomised to either a non-navigated or navigated group. In the non-navigated group, balancing was carried out using surgeon judgement. In the navigated group, balancing was carried out using navigation software. In both groups, the navigation software was used as a measuring tool.
RESULTS: Balancing of the mediolateral extension gap was superior in the navigation group (p=0.001). No significant difference was found between the two groups in balancing the mediolateral flexion gap or in achieving equal flexion and extension gaps.
CONCLUSIONS: Computer navigation offered little advantage over experienced surgeon judgement in achieving soft tissue balance in knee replacement. However, the method employed in the navigated group did provide a reproducible and objective assessment of flexion and extension gaps and may therefore benefit surgeons in training.
LEVEL OF EVIDENCE: Level I, RCT.