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Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs.

Publication ,  Journal Article
Ryan, SP; Cochrane, NH; Jiranek, WA; Seyler, TM; Wellman, SS; Bolognesi, MP
Published in: J Orthop Surg Res
June 1, 2023

BACKGROUND: Flexion instability is a common cause for revision after total knee arthroplasty (TKA); however, little objective criteria exist to determine excessive laxity in flexion. This study sought to determine the reliability of stress radiographs for flexion laxity using manual stress as well as a commercially available flexion stress device, with the hypothesis that a commercially available force device would provide increased translation compared to manual stress, and radiographic measurements would be reproducible. METHODS: Ten patients who previously underwent TKA with non-hinged components were prospectively and consecutively enrolled at a single center to undergo stress radiographs. Three lateral radiographs with the knee at 90° of flexion were obtained for each patient: rest, commercial stress device at 150N, and manual stress. Calibrated radiographs were evaluated by two raters, and inter-rater and intra-rater reliability were determined using intraclass correlation coefficients (ICC). RESULTS: Ten patients (seven female) with mean age 72 (range 55-82) years and average duration from surgery 36 (range 12-96) months were evaluated. The commercial stress device provided significantly less anterior translation than manual stress (- 0.3 mm vs. 3.9 mm; p < 0.01). Two patients reported pain with use of the stress device. Inter-observer reliability of measurements was good for commercial stress (ICC = 0.86) and excellent for manual stress (ICC = 0.94). Eighty-five percent of measurements were within 1 mm between observers. Intra-observer reliability of measurements was good to excellent for both the stress device and manual stress. CONCLUSIONS: Lateral stress radiographs may assist in the objective evaluation of flexion instability. A commercially available product provided less translation than manual stress; however, measurements were reliable and reproducible between observers. Further research is required to correlate translation with stress radiographs to patient outcomes following revision arthroplasty.

Duke Scholars

Published In

J Orthop Surg Res

DOI

EISSN

1749-799X

Publication Date

June 1, 2023

Volume

18

Issue

1

Start / End Page

396

Location

England

Related Subject Headings

  • Reproducibility of Results
  • Range of Motion, Articular
  • Orthopedics
  • Knee Joint
  • Knee
  • Joint Instability
  • Humans
  • Female
  • Child, Preschool
  • Child
 

Citation

APA
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ICMJE
MLA
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Ryan, S. P., Cochrane, N. H., Jiranek, W. A., Seyler, T. M., Wellman, S. S., & Bolognesi, M. P. (2023). Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs. J Orthop Surg Res, 18(1), 396. https://doi.org/10.1186/s13018-023-03862-x
Ryan, Sean P., Niall H. Cochrane, William A. Jiranek, Thorsten M. Seyler, Samuel S. Wellman, and Michael P. Bolognesi. “Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs.J Orthop Surg Res 18, no. 1 (June 1, 2023): 396. https://doi.org/10.1186/s13018-023-03862-x.
Ryan SP, Cochrane NH, Jiranek WA, Seyler TM, Wellman SS, Bolognesi MP. Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs. J Orthop Surg Res. 2023 Jun 1;18(1):396.
Ryan, Sean P., et al. “Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs.J Orthop Surg Res, vol. 18, no. 1, June 2023, p. 396. Pubmed, doi:10.1186/s13018-023-03862-x.
Ryan SP, Cochrane NH, Jiranek WA, Seyler TM, Wellman SS, Bolognesi MP. Evaluation of anterior translation in total knee arthroplasty utilizing stress radiographs. J Orthop Surg Res. 2023 Jun 1;18(1):396.
Journal cover image

Published In

J Orthop Surg Res

DOI

EISSN

1749-799X

Publication Date

June 1, 2023

Volume

18

Issue

1

Start / End Page

396

Location

England

Related Subject Headings

  • Reproducibility of Results
  • Range of Motion, Articular
  • Orthopedics
  • Knee Joint
  • Knee
  • Joint Instability
  • Humans
  • Female
  • Child, Preschool
  • Child