Abstract
BACKGROUND: Increased varus/valgus laxity and perceived knee instability are independently associated with poor outcomes in people with knee osteoarthritis. However, the relationship between laxity and perceived instability is unclear. OBJECTIVE: To assess whether knee extensor strength, pain, and knee laxity are related to perceived knee instability in patients with advanced knee osteoarthritis. METHODS: This was a secondary analysis of a prospective observational cohort study of 35 patients (24 female; mean ± SD age, 60 ± 8 years; body mass index, 33 ± 5 kg/m(2)) with knee osteoarthritis awaiting total knee arthroplasty (36 knees). Within 1 month before arthroplasty, we measured isometric knee extension strength and self-reported knee pain (using the Knee injury and Osteoarthritis Outcome Score pain subscale). Patients rated their perception of knee instability as moderate to severe (n = 20) or slight to none (n = 15 patients, n = 16 knees) using the Knee Outcome Survey. We measured intraoperative varus/valgus knee laxity. RESULTS: Lower knee extension strength (P = .01) and greater pain (P<.01) were associated with the perception of moderate to severe knee instability. Laxity was not related to perceived knee instability (P = .63). CONCLUSION: Knee extension strength and pain were associated with perceived instability in people with advanced osteoarthritis. Varus/valgus laxity was not related to perceived knee instability. LEVEL OF EVIDENCE: Level 2, prognostic. J Orthop Sports Phys Ther 2019;49(7):513-517. doi:10.2519/jospt.2019.8619.