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28.08.2017 | Knee Arthroplasty | Ausgabe 10/2017 Open Access

Archives of Orthopaedic and Trauma Surgery 10/2017

Varus–valgus stability at 90° flexion correlates with the stability at midflexion range more widely than that at 0° extension in posterior-stabilized total knee arthroplasty

Zeitschrift:
Archives of Orthopaedic and Trauma Surgery > Ausgabe 10/2017
Autoren:
Kazunori Hino, Tatsuhiko Kutsuna, Kunihiko Watamori, Hiroshi Kiyomatsu, Yasumitsu Ishimaru, Jun Takeba, Seiji Watanabe, Yoshitaka Shiraishi, Hiromasa Miura

Abstract

Introduction

Midflexion stability can potentially improve the outcome of total knee arthroplasty (TKA). The purpose of this study was to evaluate the correlation between varus–valgus stability at 0° of extension and 90° of flexion and that at the midflexion range in posterior-stabilized (PS)-TKA.

Materials and methods

Forty-three knees that underwent PS-TKA were evaluated. Manual mild passive varus–valgus stress was applied to the knees, and the postoperative maximum varus–valgus stability was measured every 10° throughout range of motion, using a navigation system. Correlations between the stability at 0°, 90° of flexion, and that at each midflexion angle were evaluated using Spearman’s correlation coefficients.

Results

The stability of 0° modestly correlated with that of 10°–20°, but it did not significantly correlate with that of 30°–80°. However, the stability of 90° strongly correlated with that of 60°–80°, modestly correlated with that of 40°–50°, weakly correlated with that of 20°–30°, and did not correlate with that of 10°.

Conclusions

The present study confirmed the importance of acquiring stability at 90° flexion to achieve midflexion stability in PS-TKA. However, initial flexion stability did not strongly correlate with the stability at either 0° or 90°. Our findings can provide useful information for understanding varus–valgus stability throughout the range of motion in PS-TKA. Attention to soft tissue balancing is necessary to stabilize a knee at the initial flexion range in PS-TKA.

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