Tibiofemoral instability in primary total knee replacement: A review, Part 1: Basic principles and classification

Tibiofemoral instability following total knee replacement has received little attention. However it is a cause of early and late failure and usually requires revision surgery. Several factors may be implicated including improper soft tissue balancing, flexion–extension gap mismatch and acute ligamentous injuries. Meticulous surgical technique and proper prosthetic selection at the primary procedure avoids this complication.