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Review Question - QID 1587

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QID 1587 (Type "1587" in App Search)
A 66-year-old male is undergoing a total knee arthroplasty using a fixed bearing posterior stabilized component. During intraoperative trialing of the components it is noted that the flexion gap is loose, and extension gap is appropriate. If this is not corrected, what post-operative complication is this patient most at risk of having?

Spin out of the polyethylene

15%

378/2574

Periprosthetic fracture

1%

13/2574

Posterior knee dislocation

75%

1941/2574

Osteolysis

6%

154/2574

Patellar instability

3%

68/2574

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A posteriorly stabilized knee has a post built into the polyethylene bearing that articulates with the box of the femoral component in flexion to act as a cam mechanism. If the knee is too loose in flexion, it is possible for the femoral component to "jump the post", causing a posterior dislocation.

Clarke and Scuderi review flexion instability as a mode of failure in knee replacements. They describe how this is usually due to lack of adequate balance at the time of surgery. They also report that revision surgery is usually the only way to correct symptomatic flexion instability.

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