Analysis of the Flexion Gap on In Vivo Knee Kinematics Using Fluoroscopy

There is a paucity of information on the relationships between postoperative knee laxity and in vivo knee kinematics. The correlations were analyzed in 22 knees with axial radiographs and fluoroscopy based 3D model fitting approach after a tri-condylar total knee arthroplasty. During deep knee bend activities, the medial flexion gap had significant correlations with the medial contact point (r = 0.529, P = 0.011) and axial rotation at full extension. During kneeling activities, a greater medial flexion gap caused larger anterior translation at complete contact (r = 0.568, P = 0.011). Meanwhile, the lateral flexion gap had less effect. In conclusion, laxity of the medial collateral ligament should be avoided because the magnitude of medial flexion stability was crucial for postoperative knee kinematics.