Flexion Contracture Persists If the Contracture is More Than 15° at 3 Months After Total Knee Arthroplasty

Mitsuyasu, Hiromichi; Matsuda, Shuichi; Miura, Hiromasa; Okazaki, Ken; Fukagawa, Shingo; Iwamoto, Yukihide

doi:10.1016/j.arth.2010.04.023

Cited by 43 publications

(38 citation statements)

References 12 publications

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“…While some studies have reported that the condition does not improve postoperatively [17][18][19][20], other investigators have shown gradual recovery with conservative management [19,[21][22][23][24]. It has been well established that the presence of a preoperative flexion contracture increases the risk of developing a postoperative flexion contracture [5].…”

Section: Discussionmentioning

confidence: 99%

“…This is slightly higher than that reported in the literature due to the fact that we considered any loss of extension greater than 5°to be a flexion contracture. We selected this value given that many authors have found that quadriceps muscle fatigue, anterior knee pain, altered gait mechanics, lower knee outcome scores, and patient dissatisfaction occur with a flexion contracture over 5° [1,5,8,9,19,30,34,35]. If we had defined flexion contracture as a lack of extension of 10°or more, our flexion contracture incidence at six weeks and one year would have been 5.96 % and 0 %, respectively.…”

Section: Discussionmentioning

confidence: 99%

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The natural history of a newly developed flexion contracture following primary total knee arthroplasty

Anania¹,

Abdel

Lee

et al. 2013

International Orthopaedics (SICOT)

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Purpose We investigated the incidence, natural history, and functional consequences of a newly developed flexion contracture after total knee arthroplasty (TKA). Methods Forty patients with full knee extension preoperatively who developed a postoperative flexion contracture were match-paired 1:2 with 80 patients who had full extension. The incidence of a newly developed flexion contracture, ROM, and Knee Society scores (KSS) at six weeks, four months, and one year were analysed. Results The incidence of a new flexion contracture at sixweeks was 14 %, but diminished to 5 % and 0.3 % at fourmonths and one year, respectively. One year after surgery, there was no difference in the KSS (p=0.5). Conclusions This study showed that the majority of patients who developed a new flexion contracture after TKA have full knee extension one year postoperatively. Moreover, knee extension and KSS at one year are equivalent to those patients who did not developed a flexion contracture.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The natural history of a newly developed flexion contracture following primary total knee arthroplasty

Anania¹,

Abdel

Lee

et al. 2013

International Orthopaedics (SICOT)

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“…The natural history of fixed flexion following TKA is both unpredictable and controversial [6][7][8][9][10][11]. Ideally flexion deformity should be corrected at the time of surgery.…”

Section: Introductionmentioning

confidence: 98%

The Effect of Distal Femoral Resection on Fixed Flexion Deformity in Total Knee Arthroplasty

Liu¹,

Reidy

Beller

2016

The Journal of Arthroplasty

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“…Postoperative loss of knee extension, sometimes referred to as flexion contractures, has been reported in 8% to 25% of patients having undergone total knee arthroplasty (TKA) or ACLR [1-4]. TKA patients with losses of knee extension of less than 10° in the first 3 postoperative months generally regain motion over the course of the first two postoperative years, with only 8% demonstrating lasting residual motion restriction [5]. On the contrary, 58% of patients with more severe motion restriction (≥10°) were reported to have residual loss of knee extension two years after TKA.…”

Section: Introductionmentioning

confidence: 99%

High-intensity mechanical therapy for loss of knee extension for worker's compensation and non-compensation patients

Dempsey

Branch²,

Mills³

et al. 2010

BMC Sports Sci Med Rehabil

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BackgroundKnee flexion contractures have been associated with increased pain and a reduced ability to perform activities of daily living. Contractures can be treated either surgically or conservatively, but these treatment options may not be as successful with worker's compensation patients. The purposes of retrospective review were to 1) determine the efficacy of using adjunctive high-intensity stretch (HIS) mechanical therapy to treat flexion contractures, and 2) compare the results between groups of worker's compensation and non-compensation patients.MethodsFifty-six patients (19 women, 37 men, age = 51.5 ± 17.0 years) with flexion contractures were treated with HIS mechanical therapy as an adjunct to outpatient physical therapy. Mechanical therapy was only prescribed for those patients whose motion had reached a plateau when treated with physical therapy alone. Patients were asked to perform six, 10-minute bouts of end-range stretching per day with the ERMI Knee Extensionater(r) (ERMI, Inc., Atlanta, GA). Passive knee extension was recorded during the postoperative visit that mechanical therapy was prescribed, 3 months after beginning mechanical therapy, and at the most recent follow-up. We used a mixed-model 2 × 3 ANOVA (group × time) to evaluate the change in passive knee extension between groups over time.ResultsRegardless of group, the use of adjunctive HIS mechanical therapy resulted in passive knee extension deficits that significantly improved from 10.5° ± 5.2° at the initial visit to 2.6° ± 3.5° at the 3 month visit (p < 0.001). The degree of extension was maintained at the most recent follow-up (2.0° ± 2.9°), which was significantly greater than the initial visit (p < 0.001), but did not differ from the 3 month visit (p = 0.23). The gains in knee extension did not differ between worker's compensation and non-compensation patients (p = 0.56).ConclusionsWe conclude that the adjunctive use of HIS mechanical therapy is an effective treatment option for patients with knee flexion contractures, regardless of whether the patient is being treated as part of a worker's compensation claim or not.

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Flexion Contracture Persists If the Contracture is More Than 15° at 3 Months After Total Knee Arthroplasty

Cited by 43 publications

References 12 publications

The natural history of a newly developed flexion contracture following primary total knee arthroplasty

The natural history of a newly developed flexion contracture following primary total knee arthroplasty

The Effect of Distal Femoral Resection on Fixed Flexion Deformity in Total Knee Arthroplasty

High-intensity mechanical therapy for loss of knee extension for worker's compensation and non-compensation patients

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