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Rotational laxity and collateral ligament laxity following total knee arthroplasty with rotating platform

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Abstract

Purpose

The aim of this study was to evaluate laxity in knees with pre-operative (preop) valgus alignment compared to knees with pre-operative varus alignment after total knee arthroplasty (TKA).

Methods

This was a retrospective study including 81 patients, with six years follow-up, for pre-operative valgus- or varus alignment of the leg. All patients had been supplied with the same cruciate retaining (CR) TKA with rotating platform. Clinical findings were assessed by KSS, OKS and IKDC 2000 score. Rotational knee laxity was evaluated by a validated instrument (Laxitester®) with 2 Nm torque in 30° flexion. Collateral ligament laxity was tested manually in 30° flexion with a bending moment of approximately 5 Nm. Biomechanical results were compared to the contralateral side.

Results

Thirty-one patients had a preop valgus alignment of 8.96° and 50 patients a varus leg axis of 4.99° in the mean. In the preop valgus knees rotational analysis showed an increased laxity of 10.7° compared to preop varus knees (p = 0.001). There was no significant difference in medial (valgus 2.6 mm, varus 2.5 mm) and lateral (valgus 2.8 mm, varus 2.7 mm) laxity. KSS and OKS showed no significant differences in the follow-up results. In the IKDC 2000 objective score 50 % of the preop varus knees and 25.8 % of the preop valgus knees were classified as nearly normal. The difference in the IKDC objective was highly significant (p < 0.001).

Conclusion

Preop valgus knees show a significantly increased rotational laxity but no increased collateral ligament laxity compared to pre-operative varus knees six years after TKA with rotating platform. There is a significant difference in IKDC objective.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Albert Ludwig University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany

    Hermann O. Mayr, Anke Bernstein & Norbert Suedkamp

  2. OCM Clinic of Orthopaedic and Trauma Surgery, Munich, Germany

    Maik Reinhold, Robert Hube & Amelie Stoehr

  3. Department of Traumatology and Reconstructive Surgery, Charité Universitätsmedizin, Berlin, Germany

    Philipp von Roth

Authors
  1. Hermann O. Mayr
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  2. Maik Reinhold
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  3. Robert Hube
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  4. Philipp von Roth
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  5. Anke Bernstein
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  6. Norbert Suedkamp
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  7. Amelie Stoehr
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Correspondence to Hermann O. Mayr.

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Mayr, H.O., Reinhold, M., Hube, R. et al. Rotational laxity and collateral ligament laxity following total knee arthroplasty with rotating platform. International Orthopaedics (SICOT) 38, 1379–1386 (2014). https://doi.org/10.1007/s00264-014-2308-z

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  • DOI: https://doi.org/10.1007/s00264-014-2308-z

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