The anterior–posterior laxity after total knee arthroplasty inserted with a ligament tensor

Hal, C. T. H. van; Hellemondt, Gijs G. van; Wymenga, A. B.; Jacobs, W. C. H.

doi:10.1007/s00167-007-0333-9

Cited by 27 publications

(26 citation statements)

References 16 publications

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“…We think that this could be due to the use of the tensor, which tensions the posterior cruciate ligament automatically in flexion. Other authors have reported very stable knees after using the tensor during surgery as well [7,23,29,36]. We assume that the small difference of moment arm of 3-4 mm did not lead to clinical significant differences for the patients.…”

Section: Discussionmentioning

confidence: 97%

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact

Stralen

Heesterbeek

Wymenga

2014

Knee Surg Sports Traumatol Arthrosc

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Section: Discussionmentioning

confidence: 97%

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact

Stralen

Heesterbeek

Wymenga

2014

Knee Surg Sports Traumatol Arthrosc

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“…In a recent five-year follow-up study of 50 patients with a PCL-retaining BalanSys TKR (Mathys), no cases of posterior laxity were suggesting that the PCL remained functional. 21 Others have questioned whether the PCL in an arthritic knee can be considered to be intact, 22 and some authors found increased AP laxity at later followup. 12 We believe that the use of a tensor is important for correct balancing of the flexion gap in PCL-retaining TKR.…”

Section: Discussionmentioning

confidence: 99%

Posterior cruciate ligament balancing in total knee replacement

Christen

Heesterbeek²,

Wymenga

et al. 2007

The Journal of Bone and Joint Surgery. British volume

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We have examined the relationship between the size of the flexion gap and the anterior translation of the tibia in flexion during implantation of a posterior cruciate ligament (PCL)-retaining BalanSys total knee replacement (TKR). In 91 knees, the flexion gap and anterior tibial translation were measured intra-operatively using a custom-made, flexible tensor-spacer device. The results showed that for each increase of 1 mm in the flexion gap in the tensed knee a mean anterior tibial translation of 1.25 mm (SD 0.79, 95% confidence interval 1.13 to 1.37) was produced. When implanting a PCL-retaining TKR the surgeon should be aware that the tibiofemoral contact point is related to the choice of thickness of the polyethylene insert. An additional thickness of polyethylene insert of 2 mm results in an approximate increase in tibial anterior translation of 2.5 mm while the flexed knee is distracted with a force of between 100 N and 200 N.

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“…[10][11][12] Furthermore, the amount of AP laxity required for good ROM and function after a cruciateretaining TKR, continues to be debated. 10,[13][14][15][16][17][18][19] While studies have reported that a moderate AP laxity of 5 mm to 10 mm may provide a better movement and improved function, compared with a knee that is too tight or too loose, 9,16 some studies have shown a strong positive correlation between AP laxity and ROM, suggesting that lax knees following a TKR had a better ROM. 13,16,20 Our aim, therefore, was to evaluate the effects of AP laxity on weight-bearing and ROM following a cruciate-retaining TKR.…”

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confidence: 99%

The effect of anteroposterior laxity on the range of movement and knee function following a cruciate-retaining total knee replacement

Seon

Park

Yoon

et al. 2010

The Journal of Bone and Joint Surgery. British volume

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The amount of anteroposterior laxity required for a good range of movement and knee function in a cruciate-retaining total knee replacement (TKR) continues to be debated. We undertook a retrospective study to evaluate the effects of anteroposterior laxity on the range of movement and knee function in 55 patients following the e-motion cruciate-retaining TKR with a minimum follow-up of two years. The knees were divided into stable (anteroposterior translation, < or = 10 mm, 38 patients) and unstable (anteroposterior translation, > 10 mm, 17) groups based on the anteroposterior laxity, measured using stress radiographs. We compared the Hospital for Special Surgery (HSS) scores, the Western Ontario MacMasters University Osteoarthritis (WOMAC) index, weight-bearing flexion, non-weight-bearing flexion and the reduction of flexion under weight-bearing versus non-weight-bearing conditions, which we referred to as delta flexion, between the two groups at the final follow-up. There were no differences between the stable and unstable groups with regard to the mean HHS and WOMAC total scores, as well as weight-bearing and non-weight-bearing flexion (p = 0.277, p = 0.082, p = 0.095 and p = 0.646, respectively). However, the stable group had a better WOMAC function score and less delta flexion than the unstable group (p = 0.011 and p = 0.005, respectively). Our results suggest that stable knees with laxity < or = 10 mm have a good functional outcome and less reduction of flexion under weight-bearing conditions than unstable knees with laxity > 10 mm following an e-motion cruciate-retaining TKR.

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The anterior–posterior laxity after total knee arthroplasty inserted with a ligament tensor

Cited by 27 publications

References 16 publications

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact

Different femorotibial contact points between fixed- and mobile-bearing TKAs do not show clinical impact

Posterior cruciate ligament balancing in total knee replacement

The effect of anteroposterior laxity on the range of movement and knee function following a cruciate-retaining total knee replacement

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