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. 2009 Feb;33(1):105-9.
doi: 10.1007/s00264-007-0467-x. Epub 2007 Oct 16.

Preoperative laxity in osteoarthritis patients undergoing total knee arthroplasty

Yoshinori Ishii  1 , Hideo Noguchi, Yoshikazu Matsuda, Hiroshi Kiga, Mitsuhiro Takeda, Shin-Ichi Toyabe
Affiliations

Preoperative laxity in osteoarthritis patients undergoing total knee arthroplasty

Yoshinori Ishii et al. Int Orthop. 2009 Feb.

Abstract
in English, French

A preoperative quantitative evaluation of soft tissues is helpful for planning total knee arthroplasty, in addition to the conventional clinical examinations involved in moving the knee manually. We evaluated preoperative coronal laxity with osteoarthritis in patients undergoing total knee arthroplasty by applying a force of 150 N with an arthrometer. We examined a consecutive series of 120 knees in 102 patients. The median laxity was 0 degrees in abduction and 8 degrees in adduction. The femorotibial angle on non-weight-bearing standard anteroposterior radiographs was 180 degrees and correlated with both abduction (r = -0.244, p = 0.007) and adduction (r = 0.205, p = 0.025) laxity. The results of a regression analysis suggested that the femorotibial angle is helpful for estimating both laxities. Considering the many reports on how to obtain well-balanced soft tissues, stress radiographs might help to improve the preoperative planning for gaining the optimal laxity deemed appropriate by surgeons.

Une analyse avec évaluation quantitative préopératoire des tissus mous est nécessaire dans la planification d’une prothèse totale de genou, ceci en plus des examens cliniques conventionnels, notamment en ce qui concerne l’évaluation de la mobilité. Nous avons évalué, en préopératoire, les laxités ainsi que les stades de l’arthrose chez les patients qui ont bénéficié d’une prothèse totale du genou. Ces résultats ont été réalisés à l’arthromètre. Nous avons réalisé une série consécutive de 120 genoux chez 102 patients. La laxité moyenne était de 0° en abduction et de 8° en adduction. L’angle fémoro tibial, sans appui, sur les radiographies de face et de profil était de 180° et a été corrélé avec la laxité en abduction (r = −0.244, p = 0.007) et en adduction (r = 0.205, p = 0.025). Les résultats nous montrent que l’angle fémoro tibial est utile pour estimer les laxités. Si l’on considère les différentes études et la meilleure manière d’obtenir une bonne balance ligamentaire, les radiographies en stress permettent d’optimiser le planning opératoire et d’avoir une bonne idée des laxités.

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Figures

Fig. 1a, b
Fig. 1a, b
Abduction (a osteoarthritis and b control) was measured with a Telos arthrometer at between 0° and 20° of flexion while applying a force of 150 N
Fig. 2a, b
Fig. 2a, b
Adduction (a osteoarthritis and b control) was measured with a Telos arthrometer at between 0° and 20° of flexion while applying a force of 150 N
Fig. 3a, b
Fig. 3a, b
The relationship between the femorotibial angle (FTA) and preoperative (a) abduction laxity and (b) abduction laxity. A significant correlation was observed between the FTAand joint laxity
See this image and copyright information in PMC

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