Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Flexion instability in primary total knee replacement.

Henry D Clarke1, Giles R Scuderi

  • 1Dept of Orthopedic Surgery, Insall Scott Kelly Institute for Orthopaedics and Sports Medicine, Beth Israel Medical Center, 170 East End Ave, New York, NY 10128, USA.

The Journal of Knee Surgery
|May 14, 2003
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same authorSame journal

Management of Distal Femoral Periprosthetic Fractures after Total Knee Arthroplasty: Fixation versus Revision Reconstruction.

The journal of knee surgery·2026
Same author

Balanced Peer Review in the Era of Artificial Intelligence.

The Journal of arthroplasty·2026
Same authorSame journal

When Is Distal Femoral Replacement Indicated? Insights From Periprosthetic and Native Distal Femoral Fractures Around the Knee.

The journal of knee surgery·2026
Same author

Statistical Choices in Propensity Score Matching Influence the Conclusions in Arthroplasty Outcomes Research.

The Journal of arthroplasty·2026
Same author

Preoperative Weight Loss Intervention With Glucagon-Like Peptides 1 Receptor Agonists Is Associated With Lower Complication Rates Following Primary Total Knee Arthroplasty Than Preoperative Bariatric Surgery.

Arthroplasty today·2026
Same author

Time to Reimplantation: Waiting Longer May Increase the Risk of Subsequent Failure.

The Journal of arthroplasty·2026
Same journal

Factors affecting Union Rates following Fixation of Osteochondritis Dissecans of the Knees: A Systematic Review and Meta-Analysis.

The journal of knee surgery·2026
Same journal

Age and Racial Disparities in Manipulation Rates Following Total Knee Arthroplasty: An 11-Year Review.

The journal of knee surgery·2026
Same journal

Cooled Radiofrequency Ablation of the Genicular Nerve for the Treatment of Chronic Knee Pain Following Total Knee Arthroplasty: An Observational Study.

The journal of knee surgery·2026
Same journal

Comparison of Knee Extensor Mechanism, Function, and Flexion Range of Motion Between Obese and Nonobese Patients After Simultaneous Bilateral Total Knee Arthroplasty: A Retrospective Follow-up Study.

The journal of knee surgery·2026
See all related articles

Total knee replacement (TKR) can fail due to instability, particularly anterior-posterior (AP) instability in flexion. Achieving symmetric flexion and extension gaps during surgery is crucial to prevent this common TKR complication.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Total knee replacement (TKR) offers successful long-term outcomes, but failures, notably instability, can occur.
  • Anterior-posterior (AP) instability in flexion, unlike medial-lateral instability, has been less understood.
  • Ligamentous incompetence can arise, especially with cruciate-retaining prostheses, but intraoperative asymmetry is a key cause of flexion instability.

Purpose of the Study:

  • To elucidate the causes and management of anterior-posterior (AP) instability in flexion following total knee replacement (TKR).
  • To emphasize the importance of intraoperative gap balancing in preventing flexion instability.
  • To outline treatment strategies for flexion instability, including surgical revision and implant selection.

Main Methods:

Related Experiment Videos

  • Review of literature and clinical experience concerning TKR failures attributed to instability.
  • Analysis of the biomechanical factors contributing to AP instability in flexion.
  • Evaluation of surgical techniques for creating balanced flexion and extension spaces.
  • Assessment of prosthetic designs, including posterior-stabilized, constrained condylar, and hinged prostheses.

Main Results:

  • Intraoperative failure to achieve symmetric flexion and extension gaps is a primary cause of postoperative flexion instability.
  • Posterior-stabilized prostheses and balanced gaps minimize primary TKR flexion instability.
  • Nonoperative treatment for flexion instability has limited efficacy, often necessitating revision TKR.

Conclusions:

  • Meticulous creation of symmetric flexion and extension gaps during primary TKR is essential for preventing AP instability.
  • Revision TKR, adhering to gap balancing principles, is typically required for significant flexion instability.
  • Constrained or hinged prostheses are indicated when symmetric gaps cannot be achieved in complex cases.