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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2014
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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. |
format | Online Article Text |
id | pubmed-4439434 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
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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