Total knee arthroplasty for rheumatoid knee with bilateral, severe flexion contracture: report of three cases

Abe, Shuji; Kohyama, Kozo; Yokoyama, Hironobu; Matsuda, Shigeru; Terashima, Y.; Nakagawa, Natsuko; Saegusa, Yasuhiro; Fujioka, Hiroyuki

doi:10.3109/s10165-008-0079-3

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…Distal femoral resection more than 4 mm positions the joint line more proximally, which functionally lengthens the collateral ligaments and posterior capsule towards extension, without compromising stability in flexion. However, caution should be exercised in performing additional resection, since overzealous bone resection on the femoral side could alter patella-femoral kinematics and over-resection of the proximal tibia could lead to instability [5,6], while under-resection will leave behind residual flexion contracture [7]. Intra-operatively, on extension we observed that the posterolateral soft tissue sleeve was contracted.…”

Section: Discussionmentioning

confidence: 72%

Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report

Rajesh¹,

Supreeth²,

Kalyan³

2022

JKOA

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Background: Severe bilateral Fixed flexion deformity of the knees resulting from irreversible joint damage is a disabling complication of long-standing rheumatoid arthritis, associated with loss of ambulatory ability. While Total knee Arthroplasty is an effective treatment for such patients, it poses significant intra-operative technical demands and challenges with post-operative rehabilitation. Method: We report a case of Severe Fixed flexion deformity of both knees in a 46-year-old male with long-standing rheumatoid arthritis, non-ambulatory since 5 years, treated by sequential total knee arthroplasty. Results: Treating Severe bilateral Fixed flexion deformities in a non-ambulatory patient by sequential total knee Arthroplasty using standard implants yielded complete deformity correction and pain-free restoration of active range of motion in both knees with stable independent ambulation and complete restoration of lower limb function within 3 months of surgery. Conclusion: Our case is particularly remarkable for complete restoration of stable, pain-free restoration of ambulation within 3months in a patient with severe bilateral knee fixed flexion deformities who had been non-ambulatory for 5 years preceding his bilateral sequential total knee arthroplasty. Keywords: Fixed flexion deformity, Total knee arthroplasty, Common peroneal nerve, Rheumatoid arthritis.

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Section: Discussionmentioning

confidence: 72%

Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report

Rajesh¹,

Supreeth²,

Kalyan³

2022

JKOA

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“…However, it is potentially a poor strategy, as more bony cuts are needed to get the knee straight in the operation of patients with severe flexion contracture, which creates more problems with respect to instability thereby causing pain and dysfunction 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Total knee arthroplasty in patients with fixed flexion deformity

Salam

Islam²,

Khan³

et al. 2018

KYAMC j.

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Background: Fixed flexion deformity is a common accompaniment in advanced arthritis of the knee joint. Complete correction of fixed flexion deformity at the time of surgery remains challenging and technically demanding.Objectives: The purpose of our study was to assess the result of total knee replacement using a preset algorithm to assess the effect that a preoperative flexion deformity has on postoperative correction.Materials & Methods: This retrospective study reviewed severe flexion contracture of patients who underwent primary TKA and soft tissue balancing from June 2010 to July 2016. The data included preoperative, intraoperative, and postoperative evaluation at standard intervals and annual follow-up reports.Results: There were no intraoperative complications in this study. The average flexion contractures and ROM were not different between SF and MF groups (1.14 ± 0.27 vs. 1.12 ± 0.35 and 115.72 ± 15.13 vs. 118.34 ± 12.68).Conclusion: TKA can be performed successfully in knees with severe flexion contracture.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 2-7

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Effect of Nadi svedana with simultaneous passive stretching on correction of sandhi jadya

Patel¹,

Patel²,

Gupta³

et al. 2018

Journal of Ayurveda and Integrative Medicine

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Severe knee flexion contracture greater than 80° is rare and challenging to manage. It is a common complication which occurs after a prolonged course of the rheumatoid arthritis. The case was a 45 year old female patient of Ama vata (rheumatoid arthritis) with sandhijadya and sankoca (contracture deformity) who was hospitalized for 2 months. She was unable to walk since 1 year due to contracture of both knee joints. The patient came on a wheel chair and was unable to walk even with support. She was advised for contracture repair surgery which she refused. After hospitalization she was treated with Nadi svedana twice a day for 20 min each. Simultaneously, passive stretching for 45 s in every 5 min interval was done. She was treated for 2 months. The patient was instructed to continue other Ayurvedic remedies given as the Ama vata (rheumatoid arthritis) treatment. After Nadi svedana, goniometric assessment of the knees contracture was performed every week. She got satisfactory result in stiffness and pain and has been able to walk with support. Extension of both knee joints has improved up to 20° with increased range of motion. Her height has also been increased up to 1.5 cm due to improvement in the extension of the knee joints with better feeling in daily activities during 3 months of follow-up period.

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Total knee arthroplasty for rheumatoid knee with bilateral, severe flexion contracture: report of three cases

Cited by 6 publications

References 4 publications

Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report

Total Knee Arthroplasty in Bilateral Severe Fixed Flexion Deformity: A Case Report

Total knee arthroplasty in patients with fixed flexion deformity

Effect of Nadi svedana with simultaneous passive stretching on correction of sandhi jadya

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