The Use of Standard Posterior Stabilized Implants in Revision Total Knee Arthroplasty

In primary knee replacement, posterior-stabilized prostheses often are used but we wondered if by balancing the flexion and extension spaces satisfactory coronal and AP stability could be achieved without a more constrained implant. We retrospectively reviewed 61 patients who had a unilateral revision knee replacement 58 of whom had a posterior stabilized implant. The initial indication for the revision had been coronal instability in 42% and a loose tibial component in 44%. All patients were followed up for at least 4 years after the revision operation. Fifty two of 58 patients have fewer than 5 mm of anteroposterior instability. Fifty three of 58 patients had 0° to 5° of coronal instability. Patients who had either coronal or anteroposterior instability had evidence of instability usually by the 1-year followup. It did not progress in severity during the subsequent 3 years. In many patients satisfactory stability can be achieved in revision TKA with a posterior constrained implant and without implants with greater constraint.

Level of Evidence: Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence.