Comparison of Mid-Term Clinical and Radiologic Outcomes Between Measured Resection Technique and Gap Balanced Technique After Total Knee Arthroplasty Using Medial Stabilizing Technique for Severe Varus Knee: A Propensity Score-Matched Analysis

<b>Background:</b> The purpose was to compare clinical and radiologic outcomes in patients who underwent total knee arthroplasty (TKA) using the medial stabilizing technique (MST) for severe varus knee with either measured resection technique (MRT) or gap balance technique (GBT). <b>Methods:</b> Between February 2018 and August 2020, a total of 236 knees with an HKA angle greater than 15° were enrolled in this study. Propensity score matching (1:1) was done based on age, sex, body mass index (BMI), and preoperative hip-knee-ankle (HKA) angle. 67 knees were enrolled in MRT (group M) and GBT (group G), respectively. The mean follow-up duration was 76.2 and 72 months in Groups M and G. Clinical and radiologic outcomes, including hip-knee-ankle (HKA) angle, joint line distance, and femoral component rotation angle (FCRA), were compared between the groups. <b>Results:</b> Preoperative clinical and radiological measurements had shown no statistical significance between both groups. The postoperative radiologic measurements, including HKA angle, joint line distance, and FCRA, were not significantly different. Postoperative WOMAC index, KSKS, and KSFS were also not significantly different between both groups. <b>Conclusions:</b> In patients with severe varus deformity undergoing TKA with MST, clinical and radiographic outcomes-including limb alignment, joint line position, and femoral component rotation-were comparable between MRT and GBT on mid-term follow-up data.