title: Predictive risk factors for stiff knees in total knee arthroplasty.
abstract: Retrospective review of 1216 primary total knee arthroplasties (TKAs) to evaluate incidence and predictors of arthrofibrosis, defined as flexion less than 90 degrees 1 year post-TKA. Incidence of stiffness post-TKA was 3.7% (45/1216). A matched case-control study was then conducted to identify predictive factors for this outcome. Preoperative flexion and intraoperative flexion were predictive of ultimate postoperative flexion (P = .001 and P = .039, respectively). There was no correlation between postoperative stiffness and specific medical comorbidities, including diabetes. Preoperative and postoperative relative decreased patellar height and stiffness postoperative were significantly correlated (P = .001). Although stiffness post-TKA is multifactorial, careful attention to surgical exposure, restoring gap kinematics, minimizing surgical trauma to the patellar ligament/extensor mechanism, appropriate implant selection, and physiotherapy combined with a well-motivated patient may all serve to reduce the incidence of stiffness post-TKA.
authors.affiliation: Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Gandhi
authors.forename: Justin
authors.initials: J
authors.lastname: de Beer
authors.forename: James
authors.initials: J
authors.lastname: Leone
authors.forename: Danielle
authors.initials: D
authors.lastname: Petruccelli
authors.forename: Mitchell
authors.initials: M
authors.lastname: Winemaker
authors.forename: Anthony
authors.initials: A
authors.lastname: Adili
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D020370:Osteoarthritis, Knee / Q000503:physiopathology* / Q000601:surgery*; D011183:Postoperative Complications / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome