MANAGEMENT OF MEDIO-LATERAL INSTABILITY AFTER TOTAL KNEE REPLACEMENT

Abstract

SUMMARY P ostoperative instability is one of the major causes of revision TKA that may be required for various reasons, including polyethylene wear, metal wear, implant loosening, instability, infection, malposition, periprosthetic fracture, and implant breakage. Instability can be prevented with appropriate prosthesis selec¬tion and a good surgical technique in most cases. Prevention is the best treatment with regard to instability following TKA. Instability can be directly related to surgery due to flexion and extension gap mismatch or damage of the medial or lateral collateral ligament. Secondary instability may be caused by wear of the PE liner or septic or aseptic loosening or due to secondary torn ligaments such as the medial or lateral collateral ligaments or the capsule. There are several strategies for treating knee instability after TKR. A proper decision has to be made between ligamentous repair or reconstruction, leaving the components in place or changing the compo