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Updated: Oct 9, 2025
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Management of instability after primary total knee arthroplasty: an evidence-based review
Talal Al-Jabri1,2, Angela Brivio3, Nicola Maffulli4,5,6
1Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, London, SW7 2AZ, England. tjresearcharticles@hotmail.com.
Background:
Instability is one of the most common reasons for revision after a total knee replacement. It accounts for 17.4% of all single-stage revision procedures performed in the UK National Joint Registry. Through a careful patient evaluation, physical assessment and review of investigations one can identify the likely type of instability.
Aims:
To critically examine the different types of instability, their presentation and evidence-based management options.
Method:
A comprehensive literature search was conducted to identify articles relevant to the aetiology and management of instability in total knee replacements.
Results:
Instability should be categorised as isolated or global and then, as flexion, mid-flexion, extension or recurvatum types. By identifying the aetiology of instability one can correctly restore balance and stability.
Conclusion:
With careful judgement and meticulous surgical planning, instability can be addressed and revision surgery can provide patients with successful outcomes.
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