Sina Babazadeh1, Michelle M Dowsey1, Michael G Vasimalla2, James D Stoney2, Peter F M Choong1. 1. Department of Orthopaedics, St. Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia. 2. Department of Orthopaedics, St. Vincent's Hospital (Melbourne), Fitzroy, Victoria, Australia.
Abstract
BACKGROUND:Gap balancing (GB) has been noted to sacrifice joint-line maintenance to improve gap symmetry. This study aims to determine whether this change affects function or quality of life in the midterm. METHODS: A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or GB (n = 51). Primary outcome measured was femoral component rotation. Secondary outcomes measured were joint-line change, gap symmetry, and function and quality-of-life outcomes. RESULTS: At 5 years, 83 of 103 patients (85%) were assessed. There was no significant difference between groups in terms of functional or quality of life outcomes. A subgroup analysis revealed that there was no significant association between those with asymmetrical flexion and/or extension or medial and/or lateral gaps during knee replacement and subsequent functional outcomes. No significant difference was detected with those with an elevated joint line and postoperative function. CONCLUSION: In the midterm, the resultant change in joint-line and maintained gap symmetry noted with GB does not result in significant change to function or quality of life.
RCT Entities:
BACKGROUND: Gap balancing (GB) has been noted to sacrifice joint-line maintenance to improve gap symmetry. This study aims to determine whether this change affects function or quality of life in the midterm. METHODS: A prospective blinded randomized controlled trial was completed with 103 patients randomized to measured resection (n = 52) or GB (n = 51). Primary outcome measured was femoral component rotation. Secondary outcomes measured were joint-line change, gap symmetry, and function and quality-of-life outcomes. RESULTS: At 5 years, 83 of 103 patients (85%) were assessed. There was no significant difference between groups in terms of functional or quality of life outcomes. A subgroup analysis revealed that there was no significant association between those with asymmetrical flexion and/or extension or medial and/or lateral gaps during knee replacement and subsequent functional outcomes. No significant difference was detected with those with an elevated joint line and postoperative function. CONCLUSION: In the midterm, the resultant change in joint-line and maintained gap symmetry noted with GB does not result in significant change to function or quality of life.
Authors: Paweł Skowronek; Markus Arnold; Christian Starke; Agnieszka Bartyzel; Lukas B Moser; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-04-30 Impact factor: 4.342
Authors: Mohammad M Alzahrani; Thomas J Wood; Lyndsay E Somerville; Steven J MacDonald; James L Howard; Edward M Vasarhelyi; Brent A Lanting Journal: Orthop Res Rev Date: 2020-08-20