Range of motion after arthroplasty for the stiff osteoarthritic knee.
In 28 of 1656 total knee arthroplasties (TKAs) (1.7%) performed for osteoarthritis at this institution, the preoperative arc of motion was 60 degrees or less (average 47.5 degrees; range, 20-60 degrees). The outcome of 22 of the 28 TKAs (21 patients) is reported at a mean follow-up of 52.9 months (range, 24-144 months). Eighty-two percent of the cases were managed with standard soft-tissue releases and posterior cruciate-retaining implants and 18% with a cruciate-substituting design. The joint score rose from 28.8 to 82.2 and the Knee Society Score from 24.6 to 77 points. The mean postoperative arc of motion improved by 46 degrees-93.5 degrees. At latest follow-up, 68.2% of knees achieved maximal flexion of 90 degrees or more. Manipulation was performed in 22.7%. Complications were minimal. A functionally useful range of motion is possible after total knee arthroplasty in the majority of stiff osteoarthritic knees, often without the need for posterior cruciate substitution.
Spicer
D D M
DD
The Louisville Institute for Joint Replacement and The Arthroplasty Foundation, Louisville, KY, USA. DDMSpicer@AOL.com
Curry
J I
JI
Pomeroy
D L
DL
Badenhausen
W E
WE
Schaper
L A
LA
Suthers
K E
KE
Smith
M W
MW
D019645:Arthroplasty, Replacement, Knee; D005500:Follow-Up Studies; D006801:Humans; D020370:Osteoarthritis, Knee / Q000601:surgery*; D016059:Range of Motion, Articular