title: Mid-flexion laxity is greater after posterior-stabilised total knee replacement than with cruciate-retaining procedures: A computer navigation study.
abstract: There are several methods for evaluating stability of the joint during total knee replacement (TKR). Activities of daily living demand mechanical loading to the knee joint, not only in full extension, but also in mid-flexion. The purpose of this study was to compare the varus-valgus stability throughout flexion in knees treated with either cruciate-retaining or posterior-stabilised TKR, using an intra-operative navigation technique. A total of 34 knees underwent TKR with computer navigation, during which the investigator applied a maximum varus-valgus stress to the knee while steadily moving the leg from full extension to flexion both before and after prosthetic implantation. The femorotibial angle was measured simultaneously by the navigation system at every 10° throughout the range of movement. It was found that posterior-stabilised knees had more varus-valgus laxity than cruciate-retaining knees at all angles examined, and the differences were statistically significant at 10° (p = 0.0093), 20° (p = 0.0098) and 30° of flexion (p = 0.0252).
authors.affiliation: Ehime University Graduate School of Medicine, Department of Bone and Joint Surgery, Tohon, Ehime 791-0295, Japan. hino@msc.biglobe.ne.jp
authors.forename: K
authors.initials: K
authors.lastname: Hino
authors.forename: M
authors.initials: M
authors.lastname: Ishimaru
authors.forename: Y
authors.initials: Y
authors.lastname: Iseki
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Onishi
authors.forename: H
authors.initials: H
authors.lastname: Miura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery*; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted