{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:45:19Z","timestamp":1790858719564,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,2,25]],"date-time":"2012-02-25T00:00:00Z","timestamp":1330128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The measured resection technique and the gap\u2010balancing technique are two philosophies used in total knee surgery. It is still unknown whether one or the other technique provides superior results when computer\u2010assisted surgery is performed. We hypothesized that the gap\u2010balancing technique improves joint stability because the technique relies primarily on the soft tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective controlled study was performed in 116 patients using the tibia\u2010first or femur\u2010first technique. The Columbus<jats:sup>TM<\/jats:sup> total knee system and the Orthopilot<jats:sup>\u00ae<\/jats:sup> (Aesculap<jats:sup>\u00ae<\/jats:sup> AG, Tuttlingen, Germany) navigation system were used in all cases. Sixty\u2010three patients were allocated to the femur\u2010first technique (group F) and 53 patients to the tibial first technique (group T). The mean follow\u2010up time was 11.4 \u00b1 1.1\u00a0months. The KSS, KOOS and SF\u201036 were taken prior to surgery and at the time of follow\u2010up for clinical assessment. Long\u2010leg weight\u2010bearing radiographs were performed to assess ligament alignment. Radiographs in varus and valgus stress were performed using the Telos<jats:sup>\u00ae<\/jats:sup>\u2010Instrument (Telos<jats:sup>\u00ae<\/jats:sup> GmbH, Greisheim, Germany) under a force of 15\u00a0N at the time of follow\u2010up for the assessment of medial\u2013lateral stability. The nonparametric <jats:italic>t<\/jats:italic> test (Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test) was used in order to compare the ligament stability and the scores between group F and group T.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The lateral joint space opening for groups F and T was 3.4\u00b0 \u00b1 1.4\u00b0 and 3.9\u00b0 \u00b1 1.7\u00b0, respectively (n.s.), and the medial joint space opening for groups F and T was 4\u00b0 \u00b1 1.4\u00b0 and 4.1\u00b0 \u00b1 1.7\u00b0, respectively (n.s.). The femorotibial mechanical axis for groups F and T revealed 1.4\u00b0 \u00b1 1.2\u00b0 and 0.7\u00b0 \u00b1 2.0\u00b0 of varus, respectively (<jats:italic>p<\/jats:italic> = 0.138). The clinical assessment showed significant improvement according to KSS, KOOS and SF\u201036\u00a0in all subscales. Neither of the sores showed significant differences between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The surgeon should use his\/her preferred surgical technique providing the implantation is performed with computer assistance. It remains unclear whether the same findings will occur after conventional surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-1928-3","type":"journal-article","created":{"date-parts":[[2012,2,24]],"date-time":"2012-02-24T04:08:50Z","timestamp":1330056530000},"page":"2011-2016","source":"Crossref","is-referenced-by-count":10,"title":["No difference between tibia\u2010first and femur\u2010first techniques in TKA using computer\u2010assisted surgery"],"prefix":"10.1002","volume":"20","author":[{"given":"Roland","family":"Becker","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic and Trauma Surgery City Hospital Brandenburg Hochstrasse 26 14770 Brandenburg an der Havel Germany"},{"name":"<!--<label>4<\/label>--> Department of Orthopaedics Otto\u2010von\u2010Guericke University of Magdeburg Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Malzdorf","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Praxisclinic Werdau Germany"},{"name":"<!--<label>3<\/label>--> Department of Orthopaedic and Trauma Surgery Hospital Erlabrunn Breitenbrunn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"St\u00e4rke","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Orthopaedics Otto\u2010von\u2010Guericke University of Magdeburg Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pirtkien","family":"Randolf","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Orthopaedic and Trauma Surgery Hospital Erlabrunn Breitenbrunn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Lohmann","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Orthopaedics Otto\u2010von\u2010Guericke University of Magdeburg Magdeburg 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