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Inadequate restoration of the joint line
7%
69/947
Patellar tendon rupture
4%
37/947
Excessive internal rotation of the tibial component
2%
23/947
Flexion gap instability
74%
702/947
Hyperextension of the femoral component
12%
112/947
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Instability is a leading cause of failure following total knee arthroplasty. Instability can present as global instability, extension gap (varus/valgus) instability, or flexion gap (anterior/posterior) instability. Treatment options are numerous based on the exact pathology. The radiograph reveals anterior/posterior instability with dislocation consistent with flexion gap instability. A loose flexion gap can allow the femoral component to ride above the tibial cam post mechanism, resulting in dislocation. Distal femoral augments treat extension gap instability, whereas tibial augments can treat both flexion and extension gap instability. Posterior condyle augments at the distal femur can also be used to treat flexion gap instability. Flexion gap instability is further aggravated by extension mechanism incompetence. Note the excessively thin patella on the lateral radiograph.
3.6
(7)
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