Comparison between ligament balancing and measured resection in robot-assisted total knee arthroplasty: a 2-year follow up cohort study

Abstract

Purpose: The two most commonly used techniques for gap balancing in robot-assisted total knee arthroplasty (RA-TKA) are measured resection (MR) and ligament balancing (LB). There are limited studies have reported differences in intraoperative and postoperative outcomes between MR-TKA and LB-TKA in RA-TKA. This study aims to compare the intraoperative and postoperative outcomes of primary RA-TKA between LB and MR techniques. Methods: This cohort study utilized prospectively collected data from a single center, spanning from January 2021 to December 2022. We compared the intraoperative procedures and postoperative clinical and imaging results between two groups. Results: The LB group had a thinner distal femur cut and a lower usage of thicker polyethylene. Additionally, the LB group exhibited a higher mean femoral component external rotation and greater tibial posterior slope. The rate of soft tissue release and bone recut was lower in the LB group, as was the mean C-reactive protein level. Conclusion: In RA-TKA, LB offers advantages in soft tissue protection and bone mass preservation. However, no differences were observed in clinical and radiographic outcomes after a 2-year follow-up.