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What Should the Surgeon Aim for When Performing Computer-Assisted Total Knee Arthroplasty?
Geert Van Damme, MD; Koen Defoort, MD; Yves Ducoulombier, MD; Francis Van Glabbeek, MD, PHD; Johan Bellemans, MD, PHD; Jan Victor, MD
The Journal of Bone & Joint Surgery.  2005; 87:52-58  doi:10.2106/JBJS.E.00447
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Extract

Stability of the knee is a complex issue and involves ligaments that behave differently on the medial and lateral side. Correct positioning of the components and adequate soft-tissue balancing are critical steps in successful total knee arthroplasty1. A total knee prosthesis that is implanted "too tightly" may cause limited range of motion and compromise patient satisfaction. A total knee replacement that is implanted "too loosely" will be unstable2. Medial-lateral instability is the most common type of instability and may result from incompetent collateral ligaments, incomplete correction of a preoperative deformity, or incorrect bone cuts3. Separate studies have identified instability as a leading cause of early clinical failure of a primary total knee replacement, resulting in revision within three to five years4,5.
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