The Knee, ISSN: 1873-5800, Vol: 20, Issue: 6, Page: 401-6

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

J. Joseph; P. M.S. Simpson; S. L. Whitehouse; H. W. English; W. J. Donnelly


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.


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.


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.


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.

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