title: Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty.
abstract: OBJECTIVE
  To find out if there is an association between ligament laxity measured intraoperatively and functional outcome 1 year after total knee arthroplasty (TKA).
  
  
  METHODS
  Medial and lateral ligament laxities were measured intraoperatively in extension and in 90° of flexion in 108 patients [122 knees; median age 70 (range 42-83) years]. Mechanical axes were measured preoperatively and at 1-year follow-up. Outcome measures were the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Knee Society Clinical Rating System, the Oxford Knee Score and patient satisfaction. The relationships between laxity and outcome scores were examined by median regression analyses.
  
  
  RESULTS
  Post-operative mechanical axis had a significant effect on the association between ligament laxity and KOOS. Therefore, the material was stratified on post-operative mechanical axis. In perfectly aligned and valgus-aligned TKAs, there was a negative correlation between medial laxity and all subscores in KOOS. The most important regression coefficient (β) was recorded for the effect of medial laxity in extension on activities of daily living (ADLs) (β = -7.32, p < 0.001), sport/recreation (β = -6.9, p = 0.017) and pain (β = -5.9, p = 0.006), and for the effect of medial laxity in flexion on ADLs (β = -3.11, p = 0.023) and sport/recreation (β = -4.18, p = 0.042).
  
  
  CONCLUSIONS
  In order to improve the functional results after TKA, orthopaedic surgeons should monitor ligament laxity and mechanical axis intraoperatively and avoid medial laxity more than 2 mm in extension and 3 mm in flexion in neutral and valgus-aligned knees.
  
  
  METHODS
  II.
authors.affiliation: Department of Orthopaedic Surgery, Sykehuset Innlandet, Lillehammer, Norway, eirik.aunan@gmail.com.
authors.forename: Eirik
authors.initials: E
authors.lastname: Aunan
authors.forename: Thomas Johan
authors.initials: TJ
authors.lastname: Kibsgård
authors.forename: Lien My
authors.initials: LM
authors.lastname: Diep
authors.forename: Stephan M
authors.initials: SM
authors.lastname: Röhrl
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007432:Intraoperative Period; D007593:Joint Instability / Q000503:physiopathology*; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000503:physiopathology*; D008875:Middle Aged; D010147:Pain Measurement; D063868:Patient Outcome Assessment