Abstract
Ligament balancing is considered a prerequisite for survival in total knee arthroplasty. However, there is no consensus on how to measure ligament balance intra-operatively and the degree of stability obtained after different balancing techniques is not clarified. An accurate management of ligament balance is an essential surgical factor, having repercussions on several aspects, thus minimizing the need for revision surgery. A balanced knee entails a rectangular tibio-femoral gap, that means a symmetrical medio-lateral balance at full extension and 90° of flexion, and a balanced flexion–extension gap without medio-lateral laxity or tightness.
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