Summary
Rotatory instability is well recognised following trauma to the knee, but it may also be seen in degenerative disease. The presence of chronic instability may affect the results of operative treatment of the osteoarthritic knee, as has been shown with postero-lateral rotatory instability in patients with varus deformity secondary to osteoarthritis. Recognition of these often subtle clinical entities is essential in order to improve patient selection when considering the various options for operation. An understanding of the pathomechanics of rotational instability in combination with abnormality of alignment in the joint will enable better classification of the changes which occur in osteoarthritis of the knee.
Résumé
Les instabilités chroniques rotatoires du genou sont bien connues dans le cadre de la pathologie post-traumatique; elles peuvent également être notées durant l'histoire naturelle évolutive de la pathologie degénérative du genou. De telles instabilités sont susceptibles d'influencer les résultats des traitements chirurgicaux opposables à l'arthrose du genou, comme cela a pu être observé dans des cas d'instabilité rotatoire postéro-externe, accompagnant certaines gonarthroses sur genu-varum. La reconnaissance de telles entités cliniques, le plus souvent frustes, constitue un préalable indispensable à une amélioration des indications chirurgicales en matière de gonarthrose: ostéotomie ou prothèse totale. De plus, l'identification de tels défauts de stabilité articulaire, se combinant à la déviation angulaire, devrait permettre une meilleure classification de la gonarthrose dans une double perspective épidémiologique et/ou prophylactique.
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Msika, C.C., Sedlin, E.D. Postero-lateral rotatory instability in osteoarthritis of the knee. International Orthopaedics 14, 25–28 (1990). https://doi.org/10.1007/BF00183359
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DOI: https://doi.org/10.1007/BF00183359