Total knee arthroplasty in stiff knee compared with flexible knees

Abstract

This retrospective study was done to evaluate the results of total knee arthroplasty performed on 32 patients with stiff knee, having a preoperative arc of movement between 0° and 50° (average 30°). This group of patients were matched with a group of 32 flexible knees, randomly selected from the same cohort of patients who underwent knee arthroplasty in our ward. At a mean follow-up of 4.5 years (min 2, max 11 years), seven patients of the stiff group reported complications (21.8% overall): four prosthetic infection that successively underwent removal of the implant, one skin necrosis 4 months after the intervention, one early contracture and one late stiffness of the knee. In the control group, in two cases, there was substitution of the implant due to periprosthetic infection. At the end of the study period, the clinical evaluation was not possible in four patients of the stiff and in two patients of the control group who underwent revision of the prosthetic components. An excellent or good clinical result was obtained in 92% of stiff group and in 96% of the control group patients. Although the final results achieved in these patients are worse than those of patients with flexible knee due to disadvantageous preoperative conditions and high complication rate, our results demonstrate the efficacy of the arthroplasty procedure as treatment of stiff knee.

Impact of Body Mass Index (BMI) on Early Outcomes of Total Knee Arthroplasty

“…It needs to be noted that the increased restriction of the range of motion in the operated knee joint in the second group was not reflected in higher pain severity, more limited physical activity or the total WOMAC score. Some studies indicate joint stiffness as a complication of TKA [18,19]. However, we failed to find reports relating this problem to BMI.…”

“…War to zwrócić uwa gę, że wzrost po zio mu ogra ni cze nia ru chów w ope ro wa nym sta wie ko la no wym w dru giej gru pie nie prze kła da się na więk szy po ziom do le gli wo ści bólo wych, gor szą spraw ność fi zycz ną i cał ko wi ty wy nik z kwe stio na riu sza WO MAC. Część ba dań wska zu je na wy stę po wa nie sztyw no ści sta wu ja ko jed ne go z po wikłań po prze pro wa dzo nym za bie gu [18,19]. Jed nak auto rom pra cy nie uda ło się zna le żć do nie sień czy ten pro blem jest zwią za ny z war to ścią wskaź ni ka BMI.…”

Pseudoaneurysm of the superior lateral genicular artery: case report of a rare complication after total knee arthroplasty

“…A knee with preoperative arc of motion less than 50 deg° is considered to be stiff [10,11]. Eversion of patella is the most difficult step during TKA in such knees due to contracture and fibrosis of surrounding tissue needing additional steps like lateral release, quadriceps snip, quadricepsplasty, tibial tubercle osteotomy and also skeletaonization of the proximal medial tibia [10,11].…”

“…Eversion of patella is the most difficult step during TKA in such knees due to contracture and fibrosis of surrounding tissue needing additional steps like lateral release, quadriceps snip, quadricepsplasty, tibial tubercle osteotomy and also skeletaonization of the proximal medial tibia [10,11]. During these steps the surrounding neurovascular structures are at risk and can be damaged directly by instruments or indirectly by stretch and shear force.…”

Modern Trends in Orthopedics: The Knee Arthroplasty

“…Анализу исходов эндопротезирования при тугоподвижности коленного сустава посвящена работа M. Fosco с соавторами [15]. В группе из 32 пациентов со средней предоперационной ам-плитудой движений в коленном суставе около 30° осложнения были зафиксированы в 7 (21,8%) на-блюдениях: 4 -инфекция, 1 -некроз кожи через 4 месяца, 1 -ранний рецидив контрактуры, 1 -позд-ний рецидив контрактуры.…”