Effect of Tradition and Innovation on the Technique of Total Knee Arthroplasty

Current joint registries and case series from high-volume academic institutions show that 20% of TKA failures are due to inadequate soft tissue balancing. Classical TKA surgical techniques, such as gap balancing and measured resection, rely on the surgeon's subjective intra-operative assessment of ligament tension. Surgeons tend to increase the level of intra-articular constraint with poster-stabilized implants, which are still the most used worldwide to avoid instability as an undesired complication. This intraoperative decision may have a detrimental effect on knee proprioception and patient satisfaction. Since the late 1990s, CAS has provided accurate implantation through digital mapping based on standard anatomical landmarks and an intraoperative kinematic analysis.