caa a22 4500 605456291 CHVBK 20210128100217.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00167-014-3108-0 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3108-0 Intraoperative ligament laxity influences functional outcome 1year after total knee arthroplasty [Elektronische Daten] [Eirik Aunan, Thomas Kibsgård, Lien Diep, Stephan Röhrl] Purpose: To find out if there is an association between ligament laxity measured intraoperatively and functional outcome 1year after total knee arthroplasty (TKA). Methods: Medial and lateral ligament laxities were measured intraoperatively in extension and in 90° of flexion in 108 patients [122 knees; median age 70 (range 42-83)years]. Mechanical axes were measured preoperatively and at 1-year follow-up. Outcome measures were the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Knee Society Clinical Rating System, the Oxford Knee Score and patient satisfaction. The relationships between laxity and outcome scores were examined by median regression analyses. Results: Post-operative mechanical axis had a significant effect on the association between ligament laxity and KOOS. Therefore, the material was stratified on post-operative mechanical axis. In perfectly aligned and valgus-aligned TKAs, there was a negative correlation between medial laxity and all subscores in KOOS. The most important regression coefficient (β) was recorded for the effect of medial laxity in extension on activities of daily living (ADLs) (β=−7.32, p<0.001), sport/recreation (β=−6.9, p=0.017) and pain (β=−5.9, p=0.006), and for the effect of medial laxity in flexion on ADLs (β=−3.11, p=0.023) and sport/recreation (β=−4.18, p=0.042). Conclusions: In order to improve the functional results after TKA, orthopaedic surgeons should monitor ligament laxity and mechanical axis intraoperatively and avoid medial laxity more than 2mm in extension and 3mm in flexion in neutral and valgus-aligned knees. Level of evidence: II. The Author(s), 2014 Total knee replacement nationallicence Joint instability nationallicence Ligament balancing nationallicence Monitoring, intraoperative nationallicence Knee osteoarthritis nationallicence Reference values nationallicence Aunan Eirik Department of Orthopaedic Surgery, Sykehuset Innlandet, Lillehammer, Norway aut Kibsgård Thomas Orthopaedic Department, Oslo University Hospital, Oslo, Norway aut Diep Lien Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway aut Röhrl Stephan Orthopaedic Department, Oslo University Hospital, Oslo, Norway aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/6(2015-06-01), 1684-1692 0942-2056 23:6<1684 2015 23 167 https://doi.org/10.1007/s00167-014-3108-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3108-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Aunan Eirik Department of Orthopaedic Surgery, Sykehuset Innlandet, Lillehammer, Norway aut NATIONALLICENCE 700 1- Kibsgård Thomas Orthopaedic Department, Oslo University Hospital, Oslo, Norway aut NATIONALLICENCE 700 1- Diep Lien Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway aut NATIONALLICENCE 700 1- Röhrl Stephan Orthopaedic Department, Oslo University Hospital, Oslo, Norway aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/6(2015-06-01), 1684-1692 0942-2056 23:6<1684 2015 23 167