Primary total knee arthroplasty in the valgus knee: creating a balanced soft tissue envelope

J Arthroplasty. 2001 Sep;16(6):721-9. doi: 10.1054/arth.2001.25504.

Abstract

Lateral tissue releases in valgus total knee arthroplasty frequently produce asymmetric flexion-extension gaps and ligamentous instability. This study compared 2 lateral-release sequences and quantified the effects of sequential lateral capsular ligamentous structure release. One knee from 7 paired specimens was released according to a 4-step sequence: posterior cruciate ligament (PCL), ibiotibial tract (IT band), popliteus tendon/lateral collateral ligament (PT/LCL), and biceps femoris tendon. The contralateral knees were released according to a 5-step sequence: PCL, posterolateral capsule, IT band, PT, and LCL. After each release step, flexion and extension gaps were measured and recorded for the medial and lateral aspects. The 5-step sequence produced more symmetric flexion-extension gaps, whereas the absolute magnitudes of correction were lower than with the 4-step sequence. LCL sacrifice in both sequences produced marked lateral flexion-extension gap asymmetry.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee*
  • Biomechanical Phenomena
  • Bone Malalignment / physiopathology
  • Bone Malalignment / surgery*
  • Female
  • Humans
  • Isometric Contraction / physiology
  • Joint Instability / physiopathology
  • Joint Instability / surgery
  • Ligaments, Articular / physiopathology
  • Ligaments, Articular / surgery*
  • Male
  • Matched-Pair Analysis
  • Middle Aged
  • Range of Motion, Articular / physiology
  • Treatment Outcome