Elsevier

The Journal of Arthroplasty

Volume 22, Issue 8, December 2007, Pages 1092-1096
The Journal of Arthroplasty

Original Article
The Role of Flexion Contracture on Outcomes in Primary Total Knee Arthroplasty

https://doi.org/10.1016/j.arth.2006.11.009Get rights and content

Abstract

This study examined the role that flexion contracture plays in postoperative outcomes after total knee arthroplasty using a retrospective database review. The relationships between preoperative and postoperative knee extension, walking ability, stair climbing ability, Knee Society scores, pain scores, and knee function scores were studied in 5622 knees. A preoperative flexion contracture was associated with an increased incidence of a persistent postoperative flexion deformity. A postoperative flexion contracture was associated with poorer postoperative results. Furthermore, a postoperative hyperextension deformity of greater than 10° was associated with an increased risk of suboptimal pain and Knee Society scores. Knee extension deformities play a substantial detrimental role in the functional outcome of primary total knee arthroplasty.

Section snippets

Materials and Methods

A joint arthroplasty database was used to retrospectively examine all the TKAs done at the author's institution between 1973 and 2002. There were 5622 primary TKAs during this period that had documented knee extension values preoperatively and at least 3 years postoperatively. For those patients with multiple follow-up visits, their most recent follow-up measurements were used in the data analysis. The variables of knee extension, walking ability, stair climbing ability, knee pain scores, knee

Results

Preoperative extension between 5° flexion contracture and +9° of hyperextension occurred in 62.1% of preoperative knees (Table 1). These knees were significantly less likely to have a postoperative flexion contracture of 10° or more compared with knees with a preoperative flexion contracture of 6° or more (35.0% of preoperative knees) (Table 2, Fig. 1). In addition, knees with a preoperative hyperextension recurvatum of +10° or greater had an increased incidence of a postoperative flexion

Discussion

Previous knee extension data have shown that patients with large flexion contractures preoperatively are more likely to experience a flexion contracture postoperatively [8]. Our study, involving 5622 knees, has shown that the greater the severity of the preoperative flexion contracture, the greater the chance of incurring a postoperative flexion contracture (Table 2, Fig. 1). We also observed that a large degree of hyperextension recurvatum preoperatively led to an increased incidence of

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No benefits or funds were received in support of the study.

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