Original ArticleThe Clinical Consequences of Flexion Gap Asymmetry in Total Knee Arthroplasty
Section snippets
Recruitment of Patients and Controls
Eighteen consecutive patients (median age, 71.5 years; range 53-80 years; 16 women, 2 men) with a persistent painful knee and clinically identified increased lateral flexion laxity after posterior cruciate retaining fixed-bearing total knee arthroplasty with patellar resurfacing (median postoperative follow-up of 42 months; range, 24-156 months) were included in the study. Exclusion criteria were implant loosening or infection, scar neuroma, patellar maltracking, oversized components, flexion
Results
The results of the fluoroscopic stress radiography are summarized in Table 1. Lateral joint opening in flexion was on average 4° larger in symptomatic patients than in controls, and this finding was statistically significant. Medial joint opening in flexion was not increased in either group. Medial and lateral joint opening in extension was not increased neither in the symptomatic nor in the control group. Joint opening in extension was on average 2° higher on the lateral side compared with the
Discussion
Symmetrically balanced collateral soft tissues in extension and in flexion 22, 23 and alignment of the tibial and femoral components perpendicular to the mechanical axis in the coronal plane [24] are major surgical goals in total knee arthroplasty. Erroneous resection of the tibial plateau and distal femoral condyles or inadequate soft tissue release for varus or valgus contracture will result in an asymmetric extension gap. Extension gap imbalance because of insufficient soft tissue release
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No benefits or funds were received in support of the study.