Revision of the stiff total knee arthroplasty

Christensen, Christian P.; Crawford, John J.; Olin, Matthew D.; Vail, Thomas P.

doi:10.1054/arth.2002.32105

Cited by 114 publications

(74 citation statements)

References 12 publications

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“…6 Several authors also suggested that the determination of a technical cause of stiffness would simplify treatment and avoid any unnecessary further intervention. 2,4,5,11,12 Final or mean gain in range of movement after manipulation under anaesthaesia is still a contentious subject. Whilst some authors reported enduring gains in flexion following manipulation, 7,13,14 another study reported that the gain in flexion was lost within one year after manipulation.…”

Section: Discussionmentioning

confidence: 99%

“…The definition of knee stiffness varies within the available literature; Bong et al 1 described it as limited range of motion (ROM) that affects a patient's ability to perform activities of daily living, Christensen et al 2 described it as an arc of motion less than 70 , Kim et al 3 described it as a flexion contracture of >15 and/or <75 of flexion, whereas Yercan et al 4 defined it as >10 of extension deficit and/or <95 of flexion in the first 6 weeks after TKA.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A national questionnaire survey on knee manipulation following total knee arthroplasty

Vun

Shields

Sen

et al. 2015

Journal of Orthopaedics

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Manipulation Stiff Arthrolysis a b s t r a c tBackground: Adequate range of knee motion is critical for successful total knee arthroplasty.While aggressive physical therapy is an important component, manipulation may be a necessary supplement. There seems to be a lack of consensus with variable practices existing in managing stiff postoperative knees following arthroplasty. Hence we aim to determine the current practice and trend among knee surgeons throughout the United Kingdom.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A national questionnaire survey on knee manipulation following total knee arthroplasty

Vun

Shields

Sen

et al. 2015

Journal of Orthopaedics

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“…All patients were being evaluated for possible revision as the indication for ordering the CT scan. These patients were being evaluated for one or more of the following diagnoses: patellar subluxation and anterior knee pain, patellar instability, knee instability with suspected malalignment, and knee stiffness (ROM \ 70°of flexion) [9]. All 52 scans were measured according to the protocol Berger et al described [4].…”

Section: Methodsmentioning

confidence: 99%

Inter- and Intraobserver Reliability of Two-dimensional CT Scan for Total Knee Arthroplasty Component Malrotation

Konigsberg

Hess

Hartman

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Rotational malalignment of total knee arthroplasty (TKA) has been correlated with patellofemoral maltracking, knee instability, and stiffness. CT is the most accurate method to assess rotational alignment of prosthetic components after TKA, but inter-and intraobserver reliability of CT scans for this use has not been well documented. Questions/purposes The objective of this study was to determine the inter-and intraobserver reliability and the repeatability of the measurement of TKA component rotation using two-dimensional CT scans. Methods Fifty-two CT scans of TKAs being evaluated for revision surgery were measured by three different physicians. An orthopaedic resident and attending measured the same scans twice (more than 2 weeks apart) and a musculoskeletal radiologist measured them once. To assess interobserver reliability, intraclass correlation coefficients (ICCs) with two-way mixed-effects analysis of variance models as well as 95% confidence intervals for each were done. The repeatability coefficient was calculated as well, which is defined as the difference in measurements that include 95% of the values. This indicates the magnitude of variability among measurements in the same scale, which in this study is degrees. Results The interobserver ICC measurement for the femoral component was 0.386 (poor), and it was 0.670 (good) for the tibial component. The interobserver ICC for the combined rotation measurements was 0.617 (good). The intraobserver ICC for the femoral component was 0.606 (good), and it was 0.809 (very good) for the tibial component. The intraobserver ICC for combined rotation was 0.751 (good). The intraobserver repeatability coefficient for the femoral component was 0.49°, 10.64°for the tibial component, and 12.29°for combined rotation. Conclusions In this study, the inter-and intraobserver reliability, and the repeatability, of TKA component rotation were variable. This raises concern about whether CT scan is diagnostic in the assessment of component malrotation after TKA.

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“…Patients with diabetes mellitus have lower ROM and experience more stiffness after surgery [2,22,31]. Intraoperative variables including type of implant, anesthesia type, cruciate, and collateral ligament balance are also potential determinants of final ROM [6,32]. Additionally, final outcomes may depend on adequacy of perioperative anesthetic management, use of continuous passive motion, type of rehabilitation program, and patient motivation [1-3, 7, 12, 16, 24, 26, 30, 31, 33].…”

Section: Introductionmentioning

confidence: 99%