Ligament Balancing in Revision Total Knee Arthroplasty

Ligament balancing in revision total knee arthroplasty involves placement and sizing of the femoral and tibial components and balancing procedures for the ligaments. A simplified technique is presented for sizing and positioning the implants and for balancing the ligaments. Eighty-nine knees with severe bone loss were treated with ligament-sparing exposure and bone-sparing resection techniques. The knees were stabilized by the spacer effect of the implants in flexion and extension, and nonlinked components were used. None of the knees had symptomatic instability, recurvatum, or flexion contracture. Five years after surgery the mean valgus laxity was 3° ± 2.5° and the mean varus laxity was 4.5° ± 3.3°. Laxity did not increase after 10 years followup. The techniques used in this series have proven to be simple and reproducible, and to provide long-term reliability.