ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Threshold values for stress radiographs in unstable knees after total knee arthroplasty.
Article 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 17 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
17 citing papers in PubMed, 32 citations in OpenAlex.
- Are kneeling stress radiography and the posterior sag sign associated with subjective flexion instability after posterior-stabilized total knee arthroplasty?Archives of orthopaedic and trauma surgery · 2026Article
- Is it time for a systematic and objective assessment of knee laxity? The impact of objective knee laxity after TKA on patient-reported outcomes: a comprehensive review.Archives of orthopaedic and trauma surgery · 2026Review
- Efficacy of isolated femoral revision in cruciate-retaining total knee arthroplasty instability: A comparative study.Journal of experimental orthopaedics · 2025Article
- Coronal plane stability of cruciate-retaining total knee arthroplasty in valgus gonarthrosis patients: A mid-term evaluation using stress radiographs.World journal of orthopedics · 2024Article
- Effect of posteromedial vertical capsulotomy with medial collateral ligament liberation on intraoperative medial component gap mismatch between extension and mid-flexion during total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Observational
- Mid-flexion laxity could be identified with continuous flexion-arc gap assessment in patients with a large preoperative convergence angle.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Artificial intelligence and robotics in TKA surgery: promising options for improved outcomes?Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Inter-Rater Reliability of Clinical Testing for Laxity After Knee Arthroplasty.The Journal of arthroplasty · 2022Article
- Stress Radiograph Confirmation of Translational Instability After Cruciate-Retaining Total Knee Arthroplasty.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2022Article
- 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
- Stress Radiographs in the Posterior Drawer Position at 90° Flexion Should Be Used for the Evaluation of the PCL in CR TKA with Flexion Instability.Journal of clinical medicine · 2022Article
- Muscle loaded stability reflects ligament-based stability in TKA: a cadaveric study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- [Revision TKA due to instability: diagnostics, treatment options and outcomes].Der Orthopade · 2021Review
- Diagnostic Algorithm in Patients with Flexion Instability after Cruciate-Retaining Total Knee Arthroplasty: A Case Report.Clinics and practice · 2021Article
- Reasons for failure in primary total knee arthroplasty - An analysis of prospectively collected registry data.Journal of orthopaedicsArticle
- Passive Laxity in Patients With Subjective Instability Following a Cruciate-Retaining Total Knee Arthroplasty: A Pilot Study.JB & JS open accessArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe primary aim of this study was to investigate the potential benefit of stress radiographs for diagnosis of unstable total knee arthroplasty (TKA) and to identify clinically relevant cut-off values to differentiate between unstable and stable TKAs.
methodsData of 40 patients with 49 cruciate retaining (CR) TKA who underwent stress radiographs as part of the diagnostic algorithm in a painful knee clinic were prospectively collected. Anterior and posterior stress radiographs were done in 90° and 15° flexion, varus-valgus stress radiographs in 0° and 30° knee flexion. Knee laxity was measured in mm and degrees by two independent observers using standardized landmarks. Intra- and inter-observer single measure intraclass correlations were between 0.92 to 1 and 0.89 to 1, respectively. For evaluation and investigation of the potential cut-off values, two groups of patients with and without revision surgery due to instability were compared. Radiographic measures of standardized z values according to the group without revision due to instability were used to calculate average and maximum laxity z-scores.
resultsKnees undergoing revision TKA due to instability showed significantly (p < 0.001) lower (KSS) pain/function scores (94 ± 6.3, range 80-100; control group: 112 ± 19.2, range 80-148) and total KSS scores when compared to the control group. The laxity values of patients with instability were significantly higher in terms of mean values (p < 0.01) when compared to the control group. The maximum laxity z-score showed the strongest difference between the groups (R
conclusionStandardized stress radiographs are helpful tools for diagnosis of instability after TKA. The established cut-off values help to guide decision making in this challenging group of patients. However, laxity values should not be considered as the only criteria for diagnosis of unstable TKA. LEVEL OF EVIDENCE: IV.
Indexed as
Identifiers
What OpenQuestion holds
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.