Influence of intra-operative joint gap on post-operative flexion angle in osteoarthritis patients undergoing posterior-stabilized total knee arthroplasty

Recently, we developed a new tensor for total knee arthroplasty (TKA) procedures enabling soft tissue balance assessment throughout the range of motion while reproducing post-operative joint alignment with the patello-femoral (PF) joint reduced and the tibiofemoral joint aligned. Using the tensor with a computer-assisted navigation system, we investigated the relationship between various intra-operative joint gap values and their post-operative flexion angles. An increased value during the extension to flexion gap and a decreased value during the flexion to deep flexion gap with PF joint reduced, not everted, showed an inverse correlation with post-operative knee flexion angle, not pre-operative flexion angle. In conclusion, understanding the characteristics of joint gap kinematics in posterior-stabilized TKA under physiological and reproducible joint conditions may enable the prediction of the post-operative flexion angle and help to determine the appropriate intra-operative joint gap.