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Furthermore, risks associated with over release, and the necessity of medial release, are discussed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The different medial release sequences are discussed in relation to pre\u2010operative deformity, along with potential complications associated with medial release. It was found that release sequences may include the deep and superficial components of the medial collateral ligament, the posteromedial capsule, the posterior oblique ligament, the pes anserinus (pes A), and tendons of the semimembranosus and medial gastrocnemius muscle. The sequences described were found to vary substantially between studies, and very few studies had systematically quantified the effect of each release on balance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While medial release is the standard intraoperative mode of balancing, there is a lack of evidence to support current methods. The correct method for defining intraoperatively the sequence, extent and magnitude of releases required remains ill\u2010defined. It could be argued that the classic extensive medial release may be unnecessary and may be associated with iatrogenic injury to the pes A and saphenous nerve, instability and abnormal knee kinematics. Minimal medial release may allow for improved soft tissue balancing leading ultimately to improved functional outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>V (expert opinion).<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-014-3148-5","type":"journal-article","created":{"date-parts":[[2014,7,4]],"date-time":"2014-07-04T11:51:26Z","timestamp":1404474686000},"page":"3100-3112","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Lack of evidence to support present medial release methods in total knee arthroplasty"],"prefix":"10.1002","volume":"22","author":[{"given":"Nicola C.","family":"Hunt","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Newcastle Freeman University Hospital NE2 4HH Newcastle upon Tyne UK"},{"name":"Institute of Cellular Medicine Medical School Framlington Place Newcastle University NE2 4HH Newcastle upon Tyne 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