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Updated: May 18, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

Instability following total knee arthroplasty.

E Carlos Rodriguez-Merchan¹

¹Department of Orthopaedic Surgery, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain.

HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery

|October 2, 2012

Summary

Knee prosthesis instability (KPI) after total knee arthroplasty (TKA) often requires revision surgery. Identifying risk factors and choosing appropriate implant constraints are crucial for preventing and treating TKA instability.

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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris group...

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Reconstructive Surgery

Background:

Knee prosthesis instability (KPI) is a significant cause of total knee arthroplasty (TKA) failure.
The optimal degree of constraint for TKA implants remains a subject of debate.

Purpose of the Study:

To define knee prosthesis instability (KPI) in total knee arthroplasty (TKA).
To analyze risk factors associated with KPI.
To review strategies for preventing and treating KPI.

Main Methods:

A systematic literature search of PubMed (MEDLINE) from 2000-2010 was conducted.
Keywords used were 'TKA' and 'instability'.
Seventeen key articles addressing KPI diagnosis and treatment were selected.

Keywords:

arthroplasty instability knee prevention risk factors treatment

Related Experiment Videos

Last Updated: May 18, 2026

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Individualized Stem-positioning in Calcar-guided Short-stem Total Hip Arthroplasty

Published on: February 27, 2018

Main Results:

Patient-related risk factors for KPI include significant deformity, ligament release, neuromuscular conditions, and hip/foot deformities.
Appropriate implant selection and surgical technique can prevent most KPI.
Sacrificing the posterior cruciate ligament (PCL) is indicated in specific complex cases.

Conclusions:

Instability following TKA is a common indication for revision surgery.
Knees with deformity, rheumatoid arthritis, or post-traumatic arthritis require more constrained TKA designs.
Successful revision for KPI necessitates addressing the underlying cause of instability.