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structures including MCL cut for achievement of well-balanced knee [22], however, we avoidedthis procedure considering potential widening of joint gap with elongation of the lowerextremity and consequently patella baja as a result of joint line elevation with thickerpolyethylene insert. Therefore, the results in the series of study may be based on these operativeprocedures. However, some surgeons reported that post-operative lateral ligamentous laxity inthe varus knee immediate after TKA diminished with time [30]. They assessed stressradiographs of the knees using a Telos SE arthrometer and found that 8.6 degrees of laterallaxity at extension diminished to 5.1 degrees at 3 months after TKA. Considering post-operativecourse, our intra-operative results 4.2 degrees of lateral laxity at extension in the knee with thevarus alignment > 20º group may be acceptable.. Our study has some limitations. TKA procedures with a new tensor in the present study wereperformed following the independent cut manner, in which soft tissue balance was assessedafter the bone cuts. Regarding rotational alignment of the femoral component, superiority oftechniques for positioning the femoral component in flexion using measured resection techniqueor tensioned gap technique has been controversial [31-36]. The tensor used in this study can beused for TKAs with tensioned gap technique as well [37]. Following tibia cut first, we candetermine the rotational alignment of the femoral component in flexion using the tensor. Afterthat, depending on the balance, we can perform the posterior cut of the femur. Accordingly, inthe near future, we should compare these techniques to acquire the real aligned soft tissuebalance post-operatively.In the present study, we elucidate the intra-operative soft tissue balance kinematic patternduring PS TKA when they are evaluated while preserving a more physiological condition of theknee observed depending on pre-operative deformity. We believe that this pattern is morereflective of the true post-operative kinematics, and thus by maintaining a reduced patella foreach intra-operative measurement, the surgeon will be able to adjust the soft tissue balancemore accurately and thereby expect a better post-operative outcome.AcknowledgmentsThe authors acknowledge Mrs. Janina Tubby for her assistance in preparation of thismanuscript.References1. Insall JN, Tria AJ, Scott WN. The total condylar knee prosthesis: the first 5 years. ClinOrthop Relat Res 1979; 145: 68-.772. Insall JN, Binazzi R, Soudry M, Mestriner LA. Total knee arthroplasty. Clin Orthop RelatRes 1985; 192: 13-25.3. Dorr LD, Boiardo RA. Technical consideration in total knee arthroplasty. Clin OrthopRelat Res 1986; 205: 5-11.4. Bathis H, Perlick L, Tingart M, Luring C, Perlick C, Grifka J.Radiological results ofimage-based and non-image-based computer-assisted total knee arthroplasty. Int Orthop.2004;28(2):87-90..5. Jenny JY, Boeri C. [Computer-assisted implantation of atotal knee arthroplasty: a casecontrolledstudy in comparison with classical instrumentation]. Rev Chir OrthopReparatrice Appar Mot. 2001; 87: 645-52. French.6. Laskin RS, Beksac B. Computer-assisted navigation in TKA: where we are and where weare going. Clin Orthop Relat Res. 2006; 452:127-31. Review.7. Martin A, Wohlgenannt O, Prenn M, Oelsch C, Strempel A. Imageless Navigation forTKA Increases Implantation Accuracy. Clin Orthop Relat Res. 2007;460:178-84.8. Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A. Positioning of total kneearthroplasty with and without navigation support. A prospective, randomized study. JBone Joint Surg Br 2003; 85-A: 830-5.9. Stulberg SD, Loan P, Sarin V. Computer-assisted navigation in total knee replacement:file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]