Management of instability after primary total knee arthroplasty: an evidence-based review

Journal of Orthopaedic Surgery and Research

Nicola Maffulli¹  Angela Brivio²  David Barrett³  Talal Al-Jabri⁴ 

[1] Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy;Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, Queen Mary University of London, 275 Bancroft Road, E1 4DG, London, England;School of Pharmacy and Bioengineering, Keele University School of Medicine, ST5 5BG, Stoke on Trent, UK;Department of Trauma and Orthopaedic Surgery, Istituto Clinico Città Studi, Milano, Via Niccolò Jommelli, 17, 20131, Milano, MI, Italy;King Edward VII’s Hospital, 5-10 Beaumont Street, Marylebone, W1G 6AA, London, England;Spire Hospital, SO16 6UY, Southampton, UK;School of Engineering Sciences, University of Southampton, SO17 1BJ, Highfield, Southampton, UK;Trauma and Orthopaedic Surgery, Department of Surgery and Cancer, Imperial College London, SW7 2AZ, London, England;King Edward VII’s Hospital, 5-10 Beaumont Street, Marylebone, W1G 6AA, London, England;

关键词: Recurvatum;    Flexion;    Extension;    Mid-flexion;    Knee Replacement;    Instability;    Revision;   

DOI  :  10.1186/s13018-021-02878-5

来源: Springer

【 摘 要 】

BackgroundInstability is one of the most common reasons for revision after a total knee replacement. It accounts for 17.4% of all single-stage revision procedures performed in the UK National Joint Registry. Through a careful patient evaluation, physical assessment and review of investigations one can identify the likely type of instability.AimsTo critically examine the different types of instability, their presentation and evidence-based management options.MethodA comprehensive literature search was conducted to identify articles relevant to the aetiology and management of instability in total knee replacements.ResultsInstability should be categorised as isolated or global and then, as flexion, mid-flexion, extension or recurvatum types. By identifying the aetiology of instability one can correctly restore balance and stability.ConclusionWith careful judgement and meticulous surgical planning, instability can be addressed and revision surgery can provide patients with successful outcomes.

【 授权许可】

CC BY