J Knee Surg 2015; 28(02): 097-104
DOI: 10.1055/s-0034-1396080
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Instability after Total Knee Arthroplasty

David Clinton McNabb
1   Colorado Joint Replacement, Denver, Colorado
,
Raymond H. Kim
1   Colorado Joint Replacement, Denver, Colorado
2   Department of Mechanical and Materials Engineering, University of Denver, Denver, Colorado
4   Department of Orthopaedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
,
Bryan D. Springer
3   OrthoCarolina Hip and Knee Center, Charlotte, North Carolina
4   Department of Orthopaedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia
› Author Affiliations
Further Information

Publication History

29 August 2014

23 October 2014

Publication Date:
17 December 2014 (online)

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Abstract

Total knee arthroplasty (TKA) has shown to portend good long-term survivorship and excellent patient satisfaction. There are various etiologies of failure of a TKA. Instability is a major cause of the need for revision. Often, increased constraint is needed to supplement or perform the function of incompetent ligament and soft tissue structures. Posterior cruciate retaining (PCR) TKA has the least constraint. Posterior cruciate substituting (PS) TKA increases sagittal constraint. Varus–valgus constraint (VVC) adds a marked increase in coronal stability. The ultimate in constraint in TKA is a linked hinged implant. In revision TKA, it is the surgeon's responsibility to implant the prosthesis with the necessary constraint to impart adequate stability.