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← Return to Knee Replacement Imbalance
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Joint Replacements | Last Active: Apr 17 2:57pm | Replies (7)
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What ligaments are tight? In 99% of TKRs the ACL is removed and in many the PCL is also removed. So one or both cannot be tight as they don't exist.
It sounds like you may have an alignment issue. Do you know what kind of alignment your OEM surgeon did? Traditional surgery would do a mechanical alignment which essentially means drawing a straight line down the leg. More recently surgeons have been attempting to restore the natural alignment of the patient, not an arbitrary standard. My surgeon did a Functional alignment; others are doing kinematic or inverse kinematic.
You say you can't get a straight answer from anyone. What exactly do the doctors you have seen say?
Replies to "What ligaments are tight? In 99% of TKRs the ACL is removed and in many the..."
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@steveinarizona
I've been back to my original surgical team many times with pain, swelling and with 3 dislocations. All they would ever tell me is that my knee is "unstable" and would never explain why. Not knowing why, bothered me a great deal, so I got a second opinion from another surgeon (at another hospital). He is the one who diagnosed my problem as a “flexure/extension gap imbalance”. You are correct, during my original surgery both my PCL and ACL were cut, but my Medial and Lateral Collateral Ligaments were left intact. It is these ligaments that second surgeon claimed get loose as I flex my knee. He explained, to maintain stability with my type of knee replacement that it is crucial that the gap between the Tibia and Femur remain constant as the knee is flexed and straightened. He did an examination that proved that the gap narrows as I bend my knee and the more the gap narrows the looser my Medial and Lateral Collateral Ligaments actually get. They get so loose that my knee becomes sloppy and unstable when flexed. The surgeon demonstrated this by having me sit in a chair and bend my knee just past 90 degrees. Then he took hold of my leg just below my knee and with very little effort he was able to move my lower leg all over the place. He went on further to explain that this excessive movement explains why my knee gets more unstable the more I flex my knee, He also said this why my knee is always swollen and painful. Unfortunately, he refused to speculate on how or why my knee got this way. I’d like to know how this happened, so I can move forward.