SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Midflexion instability in total knee arthroplasty: a systematic review.
Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- Metaphyseal cones and sleeves are similar in improving short- and mid-term outcomes in Total Knee Arthroplasty revisions.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Performance of medial pivot, posterior stabilized and rotating platform total knee arthroplasty based on anteroposterior stability and patient-reported outcome measures; a multicentre double-blinded randomized controlled trial of 210 knees.Archives of orthopaedic and trauma surgery · 2024Trial
- Full-flexion gap balancing-driven personalized preoperative planning for TKA: biomechanical evidence of improved load symmetry in an in vitro model.Arthroplasty (London, England) · 2026Article
- Neuromuscular Characteristics Associated with Knee Instability in Osteoarthritis and After Total Knee Replacement: A Systematic Review and Meta-Analysis.Clinics and practice · 2026Review
- Medial femoral condyle restoration technique in total knee arthroplasty.Arthroplasty (London, England) · 2026Article
- Kinematic alignment yields a reduced knee adduction moment and better range of motion compared to mechanical alignment: biomechanical considerations of a staged, bilateral total knee arthroplasty case.BMC musculoskeletal disorders · 2026Article
- Mid-term performance of a unicompartmental knee prosthesis.Journal of experimental orthopaedics · 2026Article
- Kinematic alignment doesn't tell the whole story: It's time for kinetic alignment.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Assessment of intraoperative soft tissue balance in functional alignment total knee arthroplasty: A comparative study with anatomic alignment.Journal of experimental orthopaedics · 2025Article
- Mid-Flexion Sagittal Stability of Total Knee Arthroplasty Implanted With Kinematic Alignment: A Quantitative Radiographic Laxity Study With Single-Radius Posterior-Stabilized and Condylar-Stabilized Implants.Arthroplasty today · 2025Article
- Robotic-assisted total knee arthroplasty provides better joint line and posterior condylar offset restoration than conventional total knee arthroplasty: a retrospective study of radiological outcomes.Journal of robotic surgery · 2025Article
- Joint modeling and marker set selection significantly influence functional biomechanics in end-stage knee osteoarthritis: evidence from the sit-to-stand task.Frontiers in bioengineering and biotechnology · 2025Article
- Non-hygroscopic ionogel-based humidity-insensitive iontronic sensor arrays for intra-articular pressure sensing.National science review · 2024Article
- No evidence of mid-flexion instability after robotic-assisted total knee arthroplasty as assessed by intraoperative pressure sensors.Arthroplasty (London, England) · 2024Article
- I Am Afraid I Will Not Be Able to Walk, That Is What Worries Me-The Experience of Patients with Knee Osteoarthritis before Total Knee Arthroplasty: A Qualitative Study.Journal of clinical medicine · 2024Article
- Limited medial posterior capsular release increases the intraoperative medial component gap while maintaining the joint varus angle at extension in posterior-stabilized total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- The Correlation between Objective Ligament Laxity and the Clinical Outcome of Mechanically Aligned TKA.Journal of clinical medicine · 2023Article
- Balancing the flexion gap first in total knee arthroplasty leads to better preservation of posterior condylar offset resulting in better knee flexion.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Difference in implant design affects midflexion rotational laxity in cruciate-retaining total knee arthroplasty: a computer navigation study.Journal of experimental orthopaedics · 2023Article
- Improved total knee arthroplasty pain outcome when joint gap targets are achieved throughout flexion.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this systematic review was to evaluate the evidence on the existence of midflexion instability in primary total knee arthroplasty and which factors might contribute to this condition.
methodsA comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted since the inception of the database to July 2019. All relevant articles were retrieved, and their bibliographies were hand searched for further references on midflexion instability in primary total knee arthroplasty. The search strategy yielded 28 articles. After duplicate removal titles, abstracts and full text were reviewed. Fifteen studies were assessed for eligibility, 8 studies were excluded because they did not fully comply with the inclusion criteria. Seven articles were finally included in this systematic review. Anteroposterior translation, total knee arthroplasty design such as posterior-stabilized or posterior-cruciate-retaining total knee arthroplasty, joint line position with posterior condylar offset and joint gaps were considered to significantly influence midflexion stability.
resultsBased on this systematic review anteroposterior translation of ≥ 7 mm was an independent risk factor for midflexion instability at 30° knee flexion. Joint line position can be altered by up to 5 mm without measurable changes in joint stability and both an increase and a decrease in posterior condylar offset led to 30° midflexion instability.
conclusionMidflexion instability in primary total knee arthroplasty remains to be not entirely understood. Due to the low quality of available evidence, it is difficult to make any definitive conclusions. The factors which can lead to this condition were analyzed in this review, furthermore, we did not find exhaustive evidence on midflexion instability existence as an isolated entity. Nonetheless, this review will form a baseline for future research and creates awareness for the routine assessment of midflexion instability in primary total knee arthroplasty. LEVEL OF EVIDENCE: IV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.