AUTHOR=Rezaei Arash , Moon John , Lichtig Asher , Mera Barbara , Drake Brett , Choubey Apurva S. , Kim Sunjung , Tueni Nicole , Piponov Hristo , Koh Jason , Karam Joseph , Amirouche Farid TITLE=Precision soft tissue balancing: grid-assisted pie-crusting in total knee arthroplasty JOURNAL=Frontiers in Surgery VOLUME=Volume 11 - 2024 YEAR=2024 URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2024.1331902 DOI=10.3389/fsurg.2024.1331902 ISSN=2296-875X ABSTRACT=Currently, there is a lack of consensus on optimal techniques for soft-tissue balancing to address varus and valgus deformities during total knee arthroplasty (TKA). In this manuscript, we assess the efficacy of a novel pie-crusting technique for soft-tissue balancing of the knee. More specifically, we tested progressive needle pie-crusting of the medial collateral ligament (MCL) and lateral collateral ligament (LCL) using a customized grid for addressing varus and valgus deformities of the knee, respectively. This approach can serve as a useful, algorithmic tool for orthopaedic surgeons performing TKAs.