Skip to content
Journal article

Constraint in primary total knee arthroplasty.

Morgan H, Battista V, Leopold S, Arthroplasty K ...see all

The Journal of the American Academy of Orthopaedic Surgeons, vol. 13, issue 8 (2005) pp. 515-24

  • 2


    Mendeley users who have this article in their library.
  • N/A


    Citations of this article.
  • N/A


    ScienceDirect users who have downloaded this article.
Sign in to save reference


Instability is an important cause of failure following total knee arthroplasty. Increasing component constraint may reduce instability, but doing so also can cause increased forces to be transmitted to fixation and implant interfaces, which may lead to premature aseptic loosening. Constraint is defined as the effect of the elements of knee implant design that provides the stability needed to counteract forces about the knee after arthroplasty in the presence of a deficient soft-tissue envelope. Determining the amount of constraint necessary can be challenging. Most primary total knee arthroplasties are performed for knees without substantial deformity or the need for difficult ligament balancing; in these cases, either a posterior-stabilized or a posterior cruciate-retaining design is appropriate. In certain situations, such as patients with prior patellectomies, rheumatoid arthritis, or substantial preoperative deformities, a posterior-stabilized knee may be favored. With their large posts, varus-valgus constrained implants typically are reserved for patients with substantial coronal plane instability, which is difficult to balance with a posterior-stabilized or cruciate-retaining implant alone. Rotating-hinge knee implants usually are recommended for patients with severe deformity or instability that cannot be managed with a varus-valgus implant.

Author-supplied keywords

  • Arthroplasty
  • Humans
  • Joint Instability
  • Joint Instability: etiology
  • Joint Instability: prevention & control
  • Knee
  • Knee Prosthesis
  • Knee: instrumentation
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Replacement

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • Hannah Morgan

  • Vincent Battista

  • Seth S Leopold

  • Knee Arthroplasty

Cite this document

Choose a citation style from the tabs below