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Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2018, Number 3

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Ortho-tips 2018; 14 (3)

Total unstable knee replacement

Guerra PJ

Language: Spanish
References: 11
Page: 147-155
PDF size: 148.78 Kb.


ABSTRACT

Total replacement is the treatment of choice for advanced osteoarthritis of the knee joint. Common causes of failure of a knee arthroplasty are infection, instability, stiffness, and osteolysis. Articular instability is a functional pathology related to laxity, ligament imbalance or frank joint incompetence secondary to multiple causes. Articular instability is a common complaint of patients dissatisfied with a total knee replacement. When a patient refers instability, it should not be taken as a diagnosis; this state should be confirmed through a complete clinical history. Then, a physical examination should be performed, looking for varus-valgus laxity in extension and evaluating the anteroposterior and flexion stability at 90o. An extensive and directed radiographic analysis must be performed. The surgeon must be clear about the type of instability he is facing and identify it accurately to find out what type of correction will lead him to perform a successful review procedure. There are three types: instability in extension, instability in flexion and genu recurvatum. The main and most effective treatment of instability is prevention.


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