When Navigating TKA, Tibia 1st Workflow Improves Functional Results Relative to Femur 1st Workflow, at 2Y Follow-up

4 pages•Published: January 5, 2026

Gérard Giordano, Laurent Angibaud and François Boux de Casson

Abstract

This comparative study evaluates functional outcomes in total knee arthroplasty (TKA) performed with a navigation system using femur-first measured resection (MR) or tibia-first gap balancing (GB) surgical workflows. A single surgeon at one center conducted all procedures using the same implant and navigation system. Data from 123 patients, including demographic information and Oxford Knee Scores (OKS) at preoperative, six weeks, one year, and two-year follow-ups, were analyzed. Results showed no significant differences in early postoperative outcomes between workflows. However, from one year onward, the GB group demonstrated superior functional results, with an OKS improvement of 5.8 points at two years, exceeding the MCID. The GB approach, which integrates joint laxity data into femoral planning, may offer better joint balance and antero-posterior stability over time.

Keyphrases: femur first, gap balancing, measured resection, navigation, tibia first, tka

In: Joshua William Giles and Aziliz Guezou-Philippe (editors). Proceedings of The 25th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 8, pages 94-97.

Links:	https://easychair.org/publications/paper/4G1p
	https://doi.org/10.29007/5bvn

BibTeX entry

@inproceedings{CAOS2025:When_Navigating_TKA_Tibia,
  author    = {Gérard Giordano and Laurent Angibaud and François Boux de Casson},
  title     = {When Navigating TKA, Tibia 1st Workflow Improves Functional Results Relative to Femur 1st Workflow, at 2Y Follow-up},
  booktitle = {Proceedings of The 25th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Joshua William Giles and Aziliz Guezou-Philippe},
  series    = {EPiC Series in Health Sciences},
  volume    = {8},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/4G1p},
  doi       = {10.29007/5bvn},
  pages     = {94-97},
  year      = {2026}}

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