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Too little posterior tibial slope
27%
189/701
Posterior translation of the femoral component
8%
58/701
Inadvertent injury to the popliteus while cutting the posterolateral femoral condyle
34%
239/701
Overly recessing the posterior cruciate ligament
21%
147/701
Elevation of the joint line
59/701
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Dislocation of the knee in posterior stabilized total knee arthroplasty occurs when the cam on the femoral component is translated anterior to the central tibial post. Excessive flexion laxity is the most common etiology of this complication. The posterior cruciate ligament is a stabilizer in flexion and is generally removed as part of the technique. The popliteus is also a stabilizer in flexion and should be protected. Inadvertent injury to the popliteus can lead to an imbalance and flexion laxity. Other surgical factors that lead to greater flexion laxity include undersizing the femoral component, anterior translation of the femoral component, and additional posterior tibial slope. Changes in the location of the joint line have an effect on both extension and flexion stability.
1.9
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