Surgical procedures for the prevention of extension-flexion gap imbalance in total knee arthroplasty.

The purpose of this study was to identify preoperative and intraoperative factors that influence extension-flexion gap imbalance in total knee arthroplasty (TKA). Ninety-three knees undergoing TKA with the modified gap balancing technique were included. Preoperative range of motion, intraoperative extension-flexion gap balance, thickness of the resected bone and radiological parameters were investigated. The preoperative flexion contracture, bone resection thickness in the medial proximal tibia, and the medial distal femur all correlated with the extension-flexion gap balance in TKA. Bone resection thickness in the medial proximal tibia and the medial distal femur were predictive of extension-flexion imbalance.