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Advances in Orthopedics
Volume 2014 (2014), Article ID 790806, 4 pages
Clinical Study

Changes in Joint Gap Balances between Intra- and Postoperation in Total Knee Arthroplasty

1Department of Orthopaedic Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba 285-8741, Japan
2Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, 1273-2 Aoba-cho, Chuo-ku, Chiba 260-0852, Japan

Received 20 August 2013; Revised 26 November 2013; Accepted 16 December 2013; Published 2 January 2014

Academic Editor: Elizaveta Kon

Copyright © 2014 Arata Nakajima et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Achieving correct soft tissue balance and preparing equal and rectangular extension and flexion joint gaps are crucial goals of TKA. Intraoperative gap balances would change postoperatively; however, changes in joint gap balances between pre- and postoperation remain unclear. To explore these changes associated with TKA, we prospectively investigated 21 posterior cruciate ligament retaining TKAs for varus knees. Intraoperative extension gap balance (iEGB) was 2.6 ± 2.0° varus versus postoperative extension gap balance (pEGB) of 0.77 ± 1.8° valgus (), while no significant difference between intraoperative flexion gap balance (iFGB) and postoperative flexion gap balance (pFGB) was observed. We also explored correlations between intraoperative and postoperative gap balances but found no significant correlations. These observations indicate that (i) surgeons should avoid excessive release of the medial soft tissue during TKA for varus knees and (ii) intraoperative gap balance may not be necessarily reflected on postoperative gap balance.