ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
Functional preoperative assessment of coronal knee laxity better predicts postoperative patient outcomes than intraoperative surgeon-defined laxity in total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Predictive pre-resection robotic ligament balancing in total knee arthroplasty is accurate across surgeons and patient factors.Journal of robotic surgery · 2026Article
- Integrating preoperative gait kinematics into total knee arthroplasty planning: Associations with intraoperative robotic laxities and prediction of postoperative function.Journal of experimental orthopaedics · 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
- CORR Insights®: Standardized Intraoperative Robotic Laxity Assessment in TKA Leads to No Clinically Important Improvements at 2 Years Postoperatively: A Randomized Controlled Trial.Clinical orthopaedics and related research · 2025Article
- Kinematic alignment in total knee replacement successfully restores the native knee phenotype in the short term.Journal of experimental orthopaedics · 2025Article
- Coronal plane alignment of the knee classification system does not reliably predict tibiofemoral joint gaps in arthritic knees undergoing total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Robotic evaluation of articular laxity (REAL) classification: a new intraoperative knee soft-tissue laxity classification using ROSA robotic software.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Functional preoperative assessment of coronal knee laxity better predicts postoperative patient outcomes than intraoperative surgeon-defined laxity in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
purposeIntraoperative laxity assessments in total knee arthroplasty (TKA) are subjective, with few studies comparing against standardised preoperative and postoperative assessments. This study compares coronal knee laxity in TKA patients awake and anaesthetised, preprosthesis and postprosthesis implantation, evaluating relationships to patient-reported outcome measures.
methodsA retrospective analysis of 49 TKA joints included preoperative and postoperative computed tomography scans, stress radiographs and knee injury and osteoarthritis outcome score (KOOS) questionnaire results preoperatively and 12 months postoperatively. The imaging was used to assess functional laxity (FL) in awake patients, whereas computer navigation measured intraoperative surgical laxity (SL) preimplantation and postimplantation, with patients anaesthetised. Varus and valgus stress states and their difference, joint laxity, were measured.
resultsSL was greater than FL in both preimplantation [8.1° (interquartile range, IQR 2.0°) and 3.8° (IQR 2.9°), respectively] and postimplantation [3.5° (IQR 2.3°) and 2.5° (IQR 2.7°), respectively]. Preimplantation, SL was more likely than FL to categorise knees as correctable to ±3° of the mechanical axis. Preoperative FL correlated with KOOS Symptoms (r = 0.33, p = .02) and quality of life (QOL) (r = 0.38, p = .01), whereas reducing medial laxity with TKA enhanced postoperative QOL outcomes (p = .02).
conclusionsFunctional coronal knee laxity assessment of awake patients is generally lower than intraoperative surgical assessments of anaesthetised patients. Preoperative SL may result in overcorrection of coronal TKA alignment, whereas preoperative FL better predicts postoperative patient outcomes and reflects the patients' native and tolerable knee laxity. Preoperative FL assessment can be used to guide surgical planning. LEVEL OF EVIDENCE: Level II.
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