Does Knee Stability in the Coronal Plane in Extension Affect Function and Outcome After Total Knee Arthroplasty?

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2014 Jun 14

PMID 24923689

Citations 14

Authors

Hiroyuki Nakahara

Ken Okazaki

Satoshi Hamai

Shigetoshi Okamoto

Umito Kuwashima

Hidehiko Higaki

Yukihide Iwamoto

Affiliations

Soon will be listed here.

Abstract

Purpose: The aim of the present study was to clarify whether varus-valgus laxities under static stress in extension, femoral condylar lift-off during walking, and patient-reported outcomes after total knee arthroplasty (TKA) were correlated with each other.

Methods: Ninety-four knees, which had undergone posterior-stabilized TKA, were analysed. The varus-valgus laxity during knee extension was measured using a stress radiograph. New Knee Society Score (KSS) questionnaires were mailed to all patients. Correlations between the values of stress radiographs and KSS were analysed. Additionally, continuous radiological images were taken of 15 patients while each walked on a treadmill to determine condylar lift-off from the tibial tray using a 3D-to-2D image-to-model registration technique. Correlations between the amount of lift-off and either the stress radiograph or the KSS were also analyzed.

Results: The mean angle measured was 5.9 ± 2.7° with varus stress and 5.0 ± 1.6° with valgus stress. The difference between them was 0.9 ± 2.8°. Varus-valgus laxities, or the differences between them, did not show any statistically significant correlation with either component of the KSS (p > 0.05). The average amount of femoral condylar lift-off during walking was 1.4 ± 0.8 mm (medial side) and 1.3 ± 0.6 mm (lateral side). The amount of lift-off did not correlate with either varus-valgus laxities or the KSS (p > 0.05).

Conclusions: No correlations were found among varus-valgus laxities under static stress in extension, femoral condylar lift-off during walking, or patient-reported outcomes after well-aligned TKA. This study suggests that small variations in coronal laxities do not influence lift-off during walking and the patient-reported outcomes.

Level Of Evidence: IV.

Citing Articles

Large angular correction of arithmetic coronal alignment is associated with residual lateral laxity after total knee arthroplasty in varus knees for Japanese patients.

Itou J, Kuwashima U, Itoh M, Okazaki K J Exp Orthop. 2024; 11(3):e12100.

PMID: 39416973 PMC: 11481397. DOI: 10.1002/jeo2.12100.

Functional preoperative assessment of coronal knee laxity better predicts postoperative patient outcomes than intraoperative surgeon-defined laxity in total knee arthroplasty.

Jagota I, Al-Dirini R, Taylor M, Twiggs J, Miles B, Liu D Knee Surg Sports Traumatol Arthrosc. 2024; 33(2):621-633.

PMID: 39224040 PMC: 11792101. DOI: 10.1002/ksa.12400.

Effect of posteromedial vertical capsulotomy with medial collateral ligament liberation on intraoperative medial component gap mismatch between extension and mid-flexion during total knee arthroplasty.

Katagiri H, Saito R, Shioda M, Jinno T, Kaneyama R, Watanabe T Knee Surg Sports Traumatol Arthrosc. 2023; 31(12):5603-5610.

PMID: 37853244 DOI: 10.1007/s00167-023-07610-w.

The Correlation between Objective Ligament Laxity and the Clinical Outcome of Mechanically Aligned TKA.

Campi S, Papalia R, Esposito C, Candela V, Gambineri A, Longo U J Clin Med. 2023; 12(18).

PMID: 37762946 PMC: 10532354. DOI: 10.3390/jcm12186007.

Limited medial posterior capsular release increases the intraoperative medial component gap while maintaining the joint varus angle at extension in posterior-stabilized total knee arthroplasty.

Katagiri H, Saito R, Shioda M, Jinno T, Watanabe T Knee Surg Sports Traumatol Arthrosc. 2023; 31(10):4187-4194.

PMID: 37195474 DOI: 10.1007/s00167-023-07425-9.

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