Mizu-Uchi H, Kawahara S, Ishibashi S, Colwell CW, Nakashima Y, D'Lima DD. Postoperative Valgus Laxity and Medial Pivot Kinematics Are Significantly Associated With Better Clinical Outcomes.
J Arthroplasty 2022;
37:S187-S192. [PMID:
35231562 DOI:
10.1016/j.arth.2022.02.088]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND
The relative impact of soft tissue balance and knee laxity on clinical outcomes after total knee arthroplasty (TKA) is not fully understood. We analyzed associations among knee laxity, kinematics, and patient-reported outcomes.
METHODS
Knee Society Scores were recorded in 67 patients before and after primary TKA for osteoarthritis with varus deformity (N = 78). Varus and valgus laxity was measured in 78 knees using stress radiographs. Knee kinematics were measured fluoroscopically during stair ascent in 16 knees.
RESULTS
On average, varus laxity decreased significantly, and valgus laxity increased significantly after TKA, although the net combined varus-valgus laxity did not change significantly. Postoperatively, the magnitude of valgus laxity correlated significantly with greater patient symptoms and satisfaction scores. Patients with medial pivot kinematics scored higher on patient satisfaction and standard activities.
CONCLUSION
We found that postoperative valgus laxity and medial pivot kinematics were significantly associated with better clinical outcomes. These results emphasize the importance of careful preoperative planning and attention to intraoperative alignment and ligament balancing.
Collapse