Development of a pneumatic tensioning device for gap measurement during total knee arthroplasty

Dai Soon Kwak, Chae Gwan Kong, Seung Ho Han, Dong Hyun Kim, Yong In

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Despite the importance of soft tissue balancing during total knee arthroplasty (TKA), all estimating techniques are dependent on a surgeon's manual distraction force or subjective feeling based on experience. We developed a new device for dynamic gap balancing, which can offer constant load to the gap between the femur and tibia, using pneumatic pressure during range of motion. Methods: To determine the amount of distraction force for the new device, 3 experienced surgeons' manual distraction force was measured using a conventional spreader. A new device called the consistent load pneumatic tensor was developed on the basis of the biomechanical tests. Reliability testing for the new device was performed using 5 cadaveric knees by the same surgeons. Intraclass correlation coefficients (ICCs) were calculated. Results: The distraction force applied to the new pneumatic tensioning device was determined to be 150 N. The interobserver reliability was very good for the newly tested spreader device with ICCs between 0.828 and 0.881. Conclusions: The new pneumatic tensioning device can enable us to properly evaluate the soft tissue balance throughout the range of motion during TKA with acceptable reproducibility.

Original languageEnglish
Pages (from-to)188-192
Number of pages5
JournalClinics in Orthopedic Surgery
Issue number3
StatePublished - Sep 2012


  • Gap measurement
  • Pneumatic tensor
  • Soft tissue balancing
  • Total knee arthroplasty


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