Agreements between different methods of gap balance estimation in cruciate-retaining total knee arthroplasty

The authors investigated the agreements between three different methods of estimating gap balance in cruciate-retaining (CR) total knee arthroplasty (TKA) with the use of a subvastus approach. One hundred consecutive CR TKAs were prospectively included in this study. After completing soft tissue release and bone cutting for CR TKA, flexion-extension gap balance was assessed using a distractor, spacer blocks, and trial components. Levels of agreement between the estimation techniques used were substantial. All three techniques were reliable in the assessment of gap balance. But, observations made during this study suggest that if more than one estimation technique is applied during CR TKA, the incidence of undetected gap imbalance can be reduced.