Does TKA improve functional outcome and range of motion in patients with stiff knees?
The main goals of TKA are pain relief and improvement of function and range of motion (ROM). To ascertain whether TKA in patients with stiff knees would relieve pain and improve functional outcome and ROM, we asked four questions: whether (1) Knee Society and WOMAC scores would improve after TKA; (2) poor preoperative ROM would improve after TKA; (3) the revision rate of TKA in stiff knees would be high; and (4) complication rates would be high in these patients after TKA. We retrospectively reviewed 74 patients (86 knees) with stiff knees (mean age, 56.8 years) who underwent TKAs with a condylar constrained or a posterior stabilized prosthesis. The minimum followup was 5 years (mean, 9.1 years; range, 5-12 years). The mean preoperative Hospital for Special Surgery knee score and Knee Society knee and functional scores were 42, 11, and 42 points, respectively, and postoperatively they were 84, 90, and 84 points, respectively. Preoperative and postoperative total WOMAC scores were 73 and 34 points, respectively. One knee (1.2%) had aseptic loosening of the tibial component and 12 knees (14%) had complications. Despite a relatively high rate of complications, most patients had substantial improvement in function.


METHODS
Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Kim
Young-Hoo
YH
The Joint Replacement Center of Korea, Ewha Womans University School of Medicine, MokDong Hospital, 911-1, MokDong, YangCheon-Gu, Seoul, 158-710, South Korea. younghookim@ewha.ac.kr
Kim
Jun-Shik
JS
D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome