Abstract
Instability after total knee arthroplasty (TKA) can include asymptomatic mid flexion laxity, flexion instability causing pain and swelling after activity, and collateral ligament insufficiency which results in loss of ambulatory ability. Mid flexion instability may occur in knees that are considered well balanced. Flexion instability resulting from greater soft tissue laxity in flexion than extension can be treated with activity restrictions, bracing, and muscle strengthening or revision TKA. Implants are constrained in the coronal plane with either a varus-valgus UHMWPE post or metal hinge mechanism. Complete collateral ligament loss generally requires use of a hinged implant to restore stability.
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