Stress Radiograph Confirmation of Translational Instability After Cruciate-Retaining Total Knee Arthroplasty

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Shah, D
Hauschild, J
Hope, D
Vizurraga, D
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2022
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https://creativecommons.org/licenses/by/4.0/
Abstract

Introduction: Late rupture of the posterior cruciate ligament (PCL) in cruciate-retaining total knee arthroplasty (TKA) can lead to increased AP instability. This results in increased stress on the medial hamstrings resulting in hamstring-based pain. We looked to identify patients with late PCL failure using a lateral stress radiograph. Methods: A prospective cohort analysis was completed at a single institution. Eligible patients were divided into two groups based on the amount of anterior knee pain. Pain was defined as a visual analog scale of greater than or equal to 3. Each group completed a visual analog scale, Knee Injury and Osteoarthritis Outcome Score Junior, Patient-Reported Outcome Measurement Information System score and underwent a lateral posterior stress/nonstress radiograph. Amount of posterior translation and posterior tibial slope was measured. Results: Patients who had painful TKAs at the follow-up had lower Knee Injury and Osteoarthritis Outcome Score Junior (45.86 ± 13.52 versus 78.00 ± 13.26 P < 0.001). Those patients were also found to have significantly higher posterior tibial translation with stress radiograph (6.89 ± 1.874 versus 3.91 ± 2.15 mm P < 0.001) and significantly increased tibial slope (6.51 ± 2.37° versus 3.98 ± 1.79°, P = 0.004). Seven of the 14 patients in the pain group underwent revision surgery, with 6 patients found to have incompetent PCLs. Discussion: Patients with increased AP translation and increased posterior tibial slope after cruciate-retaining TKA are likely to have worse pain and outcome measures.

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Journal of the AAOS Global Research & Reviews
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6
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4
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© 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Rheumatology and arthritis
Surgery
Orthoptics
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Shah, D; Hauschild, J; Hope, D; Vizurraga, D, Stress Radiograph Confirmation of Translational Instability After Cruciate-Retaining Total Knee Arthroplasty, Journal of the AAOS Global Research & Reviews, 2022, 6 (4), pp. e22.00062
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