The meta‐ analysis showed that GB techniques result ed in statistically significant improvements in the restoration of mechanical and rotational alignment and mean Knee Society Scores and Knee Society Function scores two years post‐operatively , but result ed in greater elevation of the position of the joint line .
There is no significant difference in the other radiographic data .
Conclusion This study suggests that GB may provide better radiographic and clinical outcomes than MR when used to determine mechanical rotation in TKAs
Aims There are two techniques widely used to determine the rotational alignment of the components in total knee arthroplasty ( TKA ) ;  gap balancing ( GB ) and measured resection ( MR ) .
Which technique is the best remains controversial .
We aim ed to investigate this in a systematic review and meta‐ analysis .
Effects of the Balanced Gap Technique on Femoral Component Rotation in TKA
Abstract Femoral component rotation from a  total knee prosthesis  can be determined by either a measured resection technique or a balanced gap technique . With the balanced gap implantation technique , femoral component rotation can vary freely within the restrictions produced by soft tissue structures . Because internal rotation might cause patella problems , the effect of ligament releases on femoral component rotation in a prospect i ve clinical study was studied .  Femoral component rotation  was measured intraoperatively with a tensor applied in flexion at 150 N in 87 knees . Great interpatient variability was found ; femoral component rotation , reference from the posterior condyles , ranged from −4 ° to 13 ° . There was no difference in femoral component rotation of knees with or without ligament releases in extension . However , knees with major medial release had less external femoral component rotation than knees with minor lateral releases . Preoperative alignment had no influence on femoral component rotation . The use of the balanced gap implantation technique theoretically will result in a balanced flexion gap , but the amount of femoral component rotation will be variable owing to patient variability and variation in ligament releases . Level of Evidence : Level II , therapeutic study . See the Guidelines for Authors for a complete description of levels of evidence
The meta‐ analysis showed that GB techniques result ed in statistically significant improvements in the restoration of mechanical and rotational alignment and mean Knee Society Scores and Knee Society Function scores two years post‐operatively , but result ed in greater elevation of the position of the joint line .
There is no significant difference in the other radiographic data .
Conclusion This study suggests that GB may provide better radiographic and clinical outcomes than MR when used to determine mechanical rotation in TKAs
Aims There are two techniques widely used to determine the rotational alignment of the components in total knee arthroplasty ( TKA ) ;  gap balancing ( GB ) and measured resection ( MR ) .
Which technique is the best remains controversial .
We aim ed to investigate this in a systematic review and meta‐ analysis .