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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 8, 1133-1136.
doi: 10.1302/0301-620X.86B8.15246  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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The flexion gap in normal knees

AN MRI STUDY

Y. Tokuhara, MD, Orthopaedic Surgeon1; Y. Kadoya, MD, Chief of Adult Knee Reconstruction2; S. Nakagawa, MD, Orthopaedic Surgeon1; A. Kobayashi, MD, Lecturer1; and K. Takaoka, MD, Professor1

1 Department of Orthopaedic Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka City, Osaka 545-8585, Japan.
2 Department of Orthopaedic Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai City, Osaka 591-8025, Japan.

Correspondence should be sent to Dr Y. Kadoya.

Varus and valgus joint laxity of the normal living knee in flexion was assessed using MRI. Twenty knees were flexed to 90° and were imaged in neutral and under a varus-valgus stress in an open MRI system. The configuration of the tibiofemoral joint gap was studied in slices which crossed the epicondyles of the femur.

When a varus stress was applied, the lateral joint gap opened by 6.7 ± 1.9 mm (mean ± SD; 2.1 to 9.2) whereas the medial joint gap opened by only by a mean of 2.1 ± 1.1 mm (0.2 to 4.2). These discrepancies indicate that the tibiofemoral flexion gap in the normal knee is not rectangular and that the lateral joint gap is significantly lax. These results may be useful for adequate soft-tissue balancing and bone resection in total knee arthroplasty and reconstruction surgery on ligaments.




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