The Natural History of Flexion Contracture in Total Knee Arthroplasty

Tänzer, Michael; Miller, James

doi:10.1097/00003086-198911000-00021

Cited by 67 publications

(53 citation statements)

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“…Similar results were observed by Tanzer et al who prospectively studied 33 patients for a mean duration of 55 weeks and again demonstrated that flexion contractures can improve after total knee arthroplasty (TKA) [9]. Two-year follow-up data from McPherson et al reported that in 29 patients a continued improvement in the degree of flexion contracture was observed up to two years [10]. In contrast, Tew et al studied 697 TKAs and followed them up from 1-16 years [6].…”

Section: Discussionsupporting

confidence: 73%

Patients with fixed flexion deformity after total knee arthroplasty do just as well as those without: ten-year prospective data

Cheng

Ridley

Bird

et al. 2009

International Orthopaedics (SICOT)

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Range of motion (ROM) is an important outcome variable after total knee arthroplasty (TKA). This may be compounded by a pre-existing fixed flexion deformity (FFD). We therefore examined the long-term outcomes of patients with a flexion deformity undergoing TKA compared to those without a preoperative fixed flexion deformity. Participants who had undergone TKA at our centre between 1989 and 2002 were examined preoperatively, one, five and ten years after TKA (Kinemax PS; Howmedica, Rutherford, NJ, USA). Examining those with a preoperative FFD of greater than ten degrees with complete ten year follow-up data revealed 77 individuals. Seventy seven age, sex and body mass index matched patients were identified and the effect of TKA on indices of knee function (fixed flexion, maximum flexion, total ROM and Knee Society score (KSS) in both groups were analysed using repeated measures ANOVA. A significant difference between the groups with respect to fixed flexion (p<0.001), total ROM (p=0.001) and KSS (p<0.001) was observed between baseline and year one suggesting that those with a preoperative FFD improved more than those without. A significant difference with regard to fixed flexion was also observed between years one to five (p=0.001) and just failed to reach statistical significance between five to ten years (p=0.052) between the groups. This study demonstrates that patients with a preoperative fixed flexion deformity show continued improvement in their fixed flexion up to ten years post arthroplasty and have similar outcomes to those with no preoperative fixed flexion.

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Section: Discussionsupporting

confidence: 73%

Patients with fixed flexion deformity after total knee arthroplasty do just as well as those without: ten-year prospective data

Cheng

Ridley

Bird

et al. 2009

International Orthopaedics (SICOT)

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“…Residual fixed flexion deformity of up to 10° was seen in two knees (4%) and this had corrected after 1 year of surgery. 9,10 In this study, average improvement in hospital for special surgery score for rheumatoid knee was 34. Patellar resurfacing is also a matter of controversy and in this study replacement of all patellae was done to prevent postoperative anterior knee pain.…”

Section: Discussionmentioning

confidence: 58%

Early Results of Total Condylar Knee Arthroplasty using Indian-designed Prostheses

Salgotra¹,

Kohli²,

Vishwakarma³

et al. 2017

MGM Journal of Medical Sciences

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The present study was undertaken to evaluate the results of 50 total knee replacements performed at Military Hospital Kirkee, Pune, India, using Indian-manufactured prostheses, from November 2001 to November 2005. The study group consisted of 18 males and 28 females in the mean age of 63 years for osteoarthritis and 48 years for rheumatoid arthritis (RA): 41 knees of osteoarthritis and RA in 9 knees. The followup period was 6 months to 2 years, with a mean of 14 months. Good correction of deformities was achieved for all the knees. Postoperatively, there was improvement in Knee Society Score by 69 points for osteoarthritic knees and 65 points for rheumatoid knees. Excellent results were achieved in 88% of the cases. Average postoperative range of movements achieved was 90°. The results are comparable with those following use of far costlier imported prostheses.

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“…Moreover, they showed that postoperative flexion contractures improve with conservative management during the first three years. Other investigators have demonstrated similar flexion contracture improvement with rehabilitation and physiotherapy after intraoperative correction [4,7,24]. The second aim of this study was to compare the evolution over time of this newly developed flexion contracture with those patients who did not develop a contracture postoperatively.…”

Section: Discussionmentioning

confidence: 88%

“…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%

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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The Natural History of Flexion Contracture in Total Knee Arthroplasty

Cited by 67 publications

References 0 publications

Patients with fixed flexion deformity after total knee arthroplasty do just as well as those without: ten-year prospective data

Patients with fixed flexion deformity after total knee arthroplasty do just as well as those without: ten-year prospective data

Early Results of Total Condylar Knee Arthroplasty using Indian-designed Prostheses

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

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