Primary Principles in Soft Tissue Balancing

Soft tissue balance and alignment are integral to the success of a total knee arthroplasty (TKA). In 1985 it was already reported that most failures can be attributed to incorrect ligament balance or incorrect alignment [1]. Since 1985, numerous new and improved total knee replacement systems, surgical instruments, surgical methods, and computer-assisted surgery tools have seen the light. Ligament balancing and alignment however still remain the biggest considerations that impact the successful outcome of a total knee arthroplasty.