Hybrid Integrated Approach: Beginner’s Guide to the Balancing in Knee Arthroplasty

Gap balancing and measured resection techniques form the basic guidance on soft tissue balancing in total knee arthroplasty teachings. The concepts around knee arthroplasty constantly evolving keeping the basics right. Surgeons across the globe are blending established known techniques with newer modifications. The anatomic, functional, and kinematic alignments of the prosthetic knee are frequently debated at conferences. Irrespective of the alignment principle one is following the aim is to achieve a balanced knee for better function. While balancing the knee arthroplasty the basic theme accepted worldwide is the combination of gap balancing and measured resection philosophy. The additional procedures that aid in are these soft tissue releases, lateralization of the prosthesis, reduction osteotomy, and downsizing of the implant which results into a modern current way of approaching the idea of balancing. The surgical workflow I have discussed here is actually the amalgamation of standard teachings and newer trends resulting into the Hybrid integrated technique (H) of balancing a prosthetic a total knee arthroplasty. From the orthopedic trainee point of view it is confusing to see the operating room execution is different than conventional books information. Hence, there is a need to create a beginner’s guide of the current workflow. The modern algorithm helps in balancing the soft tissue releases and bony releases to complement each other. The below-mentioned surgical workflow is not a novel approach but scientifically documenting the current practice implemented by many surgeons at various arthroplasty centers. Hence, it is not a presentation of a personal clinical case study series but an adaptation of various surgical steps to form a workflow.