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Sagittal laxity in vivo after total knee arthroplasty

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Abstract

Introduction

A stress arthrometry study of 77 knees undergoing total knee arthroplasty was performed to determine the difference in anteroposterior (AP) laxity between posterior cruciate ligament (PCL)-retaining (PCLR) and PCL-substituting (PCLS) prostheses using the Genesis I TKA.

Materials and methods

Fifty-three knees had PCLR and 24 had PCLS prostheses. The selected patients had successful arthroplasties after a minimum follow-up of 5 years. AP laxity was measured with a KT-2000 arthrometer (Medmetric, San Diego, CA, USA) using standard protocols.

Results

At 30° of flexion, there was no statistical difference in anterior (PCLR: 4.7 mm, PCLS: 4.5 mm), posterior (PCLR: 1.1 mm, PCLS: 0.7 mm), or total (PCLR: 5.8 mm, PCLS: 5.3 mm) displacement. At 75°, significant differences were seen in both anterior (PCLR: 3.3 mm, PCLS: 2.3 mm) and total (PCLR: 4.8 mm, PCLS: 3.4 mm) displacement (p=0.001 and p=0.009, respectively), although there was no statistical difference in posterior displacement (PCLR: 1.5 mm, PCLS: 1.1 mm).

Conclusion

The above values are considered the suitable degree of AP laxity in total knee arthroplasty for a satisfactory clinical outcome 5–9 years after surgery. The PCL in a PCLR prosthesis and the central tibial spine and femoral cam in a PCLS prosthesis might play comparable roles in determining the laxity in the posterior direction in these prostheses.

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Authors and Affiliations

  1. Ishii Orthopaedic and Rehabilitation Clinic, 1089 Shimo-Oshi, 361-0037, Gyoda, Saitama, Japan

    Yoshinori Ishii, Yoshikazu Matsuda & Ryo Ishii

  2. Department of Orthopaedic Surgery, Sado General Hospital, 952-1209, Sado, Niigata, Japan

    Shigeo Sakata

  3. Department of Orthopaedic Surgery, Niigata University, 1 Asahimachi, 951-8510, Niigata, Japan

    Go Omori

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  1. Yoshinori Ishii
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  2. Yoshikazu Matsuda
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Correspondence to Yoshinori Ishii.

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Ishii, Y., Matsuda, Y., Ishii, R. et al. Sagittal laxity in vivo after total knee arthroplasty. Arch Orthop Trauma Surg 125, 249–253 (2005). https://doi.org/10.1007/s00402-004-0712-3

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