Variations in Laxity After Total Knee Arthroplasty Do Not Affect Prosthesis-generated Noise
Nicholas F Cozzarelli1, Alexandra L Hohmann2, Irfan A Khan3
1Hackensack University Medical Center, Department of Orthopaedic Surgery, Hackensack, New Jersey.
Orthopedics
|March 26, 2026
Summary
Prosthesis-generated noise after total knee arthroplasty (TKA) impacts patient satisfaction, but robotic-assisted TKA (RA-TKA) laxity measurements do not predict noise occurrence. Patients without noise reported significantly better outcomes and satisfaction.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Patient Outcomes Research
Background:
- Prosthesis-generated noise is a known complication following total knee arthroplasty (TKA).
- Robotic-assisted TKA (RA-TKA) offers objective intraoperative knee laxity measurements.
- The relationship between objective laxity and noise generation in RA-TKA is not well understood.
Purpose of the Study:
- To compare intraoperative knee laxity measurements in RA-TKA patients who did and did not report prosthesis-generated noise.
- To investigate the correlation between objective laxity and subjective noise perception.
Main Methods:
- Retrospective study of 133 primary unilateral RA-TKA patients (2018-2021).
- Patients completed noise, Forgotten Joint Score (FJS), and KOOS, JR surveys.
- Intraoperative laxity data from the robotic system was analyzed.
Main Results:
- No significant differences in medial/lateral extension/flexion laxity between noise and no-noise groups.
- Patients without noise reported significantly higher satisfaction (94.8% vs 37.5%), KOOS, JR scores (79.2 vs 69.7), and FJS (60.3 vs 44.2).
Conclusions:
- Variability in knee laxities during RA-TKA does not appear to significantly influence the occurrence of prosthesis-generated noise.
- Prosthesis-generated noise negatively impacts patient satisfaction and functional outcomes despite objective laxity measurements.
