Intraoperative soft tissue balancing in total knee arthroplasty is best described by which statement?

• A. Equal flexion and extension gap sizes regardless of ligament tension
• B. Balanced flexion-extension gaps with appropriate collateral ligament tension
• C. No consideration of soft tissue balance to preserve tissues
• D. Maximizing laxity in collateral ligaments to improve ROM

Answer: (B)

The essential idea is to restore stable, natural knee movement by balancing the soft tissues so the knee has even, appropriate ligament tension through both straight (extension) and bent (flexion) positions. Intraoperatively, the surgeon aims for gaps that are balanced in flexion and extension, with the collateral ligaments providing the right amount of tension in each position. This creates a knee that is neither too tight nor too loose, allowing smooth articulation of the prosthetic components and good ROM. If the ligaments are too tight, motion is restricted and pain can result; if they’re too loose, the knee becomes unstable. So the best description is balanced flexion-extension gaps with appropriate collateral ligament tension.