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Association between anteroposterior laxity in mid-range flexion and subjective healing of instability after total knee arthroplasty. | LitMetric

Association between anteroposterior laxity in mid-range flexion and subjective healing of instability after total knee arthroplasty.

Knee Surg Sports Traumatol Arthrosc

Department of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Science, Niigata University, 1-757 Asahimachi-dori Chuo-ku, Niigata City, Niigata, 951-8510, Japan.

Published: November 2017

Purpose: Flexion instability following total knee arthroplasty (TKA) is a common indication of early revision. The association between the objective anteroposterior (AP) laxity direction in mid-range flexion and the subjective healing of instability remains unclear; thus, this study aimed to clarify this association.

Methods: In this study, 110 knees (74 females, 92 knees; 16 males, 18 knees) with medial pivot implants were examined with a median age of 79 (range 60-92) years for a median follow-up duration of 22 (range 6-125) months. AP laxity was measured using a KT-1000 arthrometer. Self-reported knee instability score was used for the subjective healing of instability.

Results: Eighty-seven knees did not feel unstable (Group 0), whereas 23 knees felt unstable (Group 1). There was a significant difference in AP displacement [Group 0: median 6 mm; range 2-15 mm and Group 1: median 8 mm; range 4-14; p < 0.0001]. The threshold value of 7 mm was determined using the area under receiver operating characteristic curve of 0.79 [95% confidence interval (CI) 0.69-0.88, p < 0.0001]. In multivariate analysis, AP displacement of ≥7 mm was an independent risk factor for feelings of instability (odds ratio 7.695; 95% CI 2.306-25.674; p = 0.001).

Conclusions: AP laxity of ≥7 mm represents a known cause of feelings of instability. By controlling AP laxity in TKAs, without stiffness in the knee, it is possible to prevent feelings of instability. The clinical relevance is that AP laxity of <7 mm is one of the target areas in TKA.

Level Of Evidence: IV.

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Source
http://dx.doi.org/10.1007/s00167-016-4375-8DOI Listing

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