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General Orthopaedics

The influence of flexion gap stability on patient satisfaction after total knee replacement

The South African Orthopaedic Association (SAOA) 58th Annual Congress



Abstract

Background

Patient satisfaction after TKR ranges from 75 to 95 percent with 5 to 20 percent of patients who are dissatisfied with their outcome. Noble has shown pain to be the most important factor in patient satisfaction after TKR with others showing patient expectation and increased age to be important. Stability of the flexion gap has been shown by Dennis to be important in wear in the long term, but to our knowledge no study has been done linking stability of the flexion gap to patient satisfaction.

Methods

65 patients underwent a computer navigated TKR with a posterior stabilized fixed bearing prosthesis by a single surgeon. Intraoperative measurements were captured of the flexion gap laxity on varus and valgus stress to evaluate stability of the flexion gap. Patients were divided into a stable group with lift off of 3 mm or less and a lax group with lift off of more than 3 mm on either side. No patient in either group had symptoms of clinical instability. This was correlated with patient satisfaction at one year postoperatively as assessed by telephonic interview.

Results

The overall satisfaction rating was 81 percent with 54 out of 65 patients satisfied with the result of their total knee replacement. Of the remaining patients 6 were not satisfied and 5 were not sure. When assessed individually the satisfaction rating was 78 percent in the lax group and 88 percent in the stable group. Flexion gap stability contributes toward patient satisfaction after a TKR and needs to be evaluated more critically.

NO DISCLOSURES