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Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty

PURPOSE: 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 kn...

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Autores principales: Aunan, Eirik, Kibsgård, Thomas Johan, Diep, Lien My, Röhrl, Stephan M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439434/
https://www.ncbi.nlm.nih.gov/pubmed/24917538
http://dx.doi.org/10.1007/s00167-014-3108-0
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author Aunan, Eirik
Kibsgård, Thomas Johan
Diep, Lien My
Röhrl, Stephan M.
author_facet Aunan, Eirik
Kibsgård, Thomas Johan
Diep, Lien My
Röhrl, Stephan M.
author_sort Aunan, Eirik
collection PubMed
description PURPOSE: 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. LEVEL OF EVIDENCE: II.
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spelling pubmed-44394342015-05-22 Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty Aunan, Eirik Kibsgård, Thomas Johan Diep, Lien My Röhrl, Stephan M. Knee Surg Sports Traumatol Arthrosc Knee PURPOSE: 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. LEVEL OF EVIDENCE: II. Springer Berlin Heidelberg 2014-06-12 2015 /pmc/articles/PMC4439434/ /pubmed/24917538 http://dx.doi.org/10.1007/s00167-014-3108-0 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Knee
Aunan, Eirik
Kibsgård, Thomas Johan
Diep, Lien My
Röhrl, Stephan M.
Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title_full Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title_fullStr Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title_full_unstemmed Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title_short Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
title_sort intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty
topic Knee
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439434/
https://www.ncbi.nlm.nih.gov/pubmed/24917538
http://dx.doi.org/10.1007/s00167-014-3108-0
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