The unstable knee: wobble and buckle.
Instability after total knee replacement (TKR) accounts for 10% to 22% of revision procedures. All patients who present for evaluation of instability require a thorough history to be taken and physical examination, as well as appropriate imaging. Deep periprosthetic infection must be ruled out by laboratory testing and an aspiration of the knee must be carried out. The three main categories of instability include flexion instability, extension instability (symmetric and asymmetric), and genu recurvatum. Most recently, the aetiologies contributing to, and surgical manoeuvres required to correct, flexion instability have been elucidated. While implant design and patient-related factors may certainly contribute to the aetiology, surgical technique is also a significant factor in all forms of post-operative instability.
Mayo Clinic, Department of Orthopaedic Surgery, 200 First St. SW, Rochester, Minnesota, 55905, USA.
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MP
Abdel
Weill Cornell Medical College of Cornell University, Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA.
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SB
Haas
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D016059:Range of Motion, Articular; D012086:Reoperation
Instability; Flexion Instability; Primary Total Knee replacement; Revision Total Knee replacement Knee arthroplasty