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Related Experiment Videos

Flexion instability without dislocation after posterior stabilized total knees.

Joseph H Schwab1, George J Haidukewych, Arlen D Hanssen

  • 1Mayo Clinic, Rochester, MN 55905, USA.

Clinical Orthopaedics and Related Research
|October 22, 2005
PubMed
Summary

Revision total knee arthroplasty effectively treats symptomatic flexion instability after posterior stabilized total knee replacement. This reliable treatment alleviates pain and improves knee stability and patient satisfaction.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering

Background:

  • Flexion instability is a known complication of cruciate-retaining total knee arthroplasty.
  • An analogous group of patients with symptomatic flexion instability without dislocation after posterior stabilized total knee arthroplasty has been identified.

Purpose of the Study:

  • To determine typical symptoms and exam findings for diagnosing flexion instability after posterior stabilized total knee arthroplasty.
  • To assess the reliability of revision total knee arthroplasty as a treatment for this condition.
  • To evaluate technical difficulties during revision surgery.

Main Methods:

  • A case series of 10 patients undergoing revision of posterior stabilized total knee arthroplasty for isolated symptomatic flexion instability between 1995 and 2001.
  • Focus on balancing flexion and extension gaps during revision surgery.

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Main Results:

  • Typical symptoms include instability without giving way, recurrent effusions, soft tissue tenderness, and significant anterior tibial translation.
  • Revision surgery reliably alleviated pain (Knee Society Pain scores improved from 68 to 89).
  • Stability improved, with 90% of patients showing < 5 mm anterior tibial translation postoperatively, and 90% reported satisfaction.

Conclusions:

  • Revision total knee arthroplasty is a reliable treatment for symptomatic flexion instability after posterior stabilized total knee arthroplasty.
  • The procedure effectively improves pain, stability, and patient satisfaction.
  • Achieving well-balanced flexion and extension gaps is key, with no significant technical difficulties reported.