title: Fixed flexion deformity and total knee arthroplasty.
abstract: Fixed flexion deformities are common in osteoarthritic   knees that are indicated for total knee arthroplasty. The lack of   full extension at the knee results in a greater force of quadriceps   contracture and energy expenditure. It also results in slower walking   velocity and abnormal gait mechanics, overloading the contralateral   limb. Residual flexion contractures after TKA have been associated   with poorer functional scores and outcomes. Although some flexion contractures may resolve with time after   surgery, a substantial percentage will become permanent. Therefore,   it is essential to correct fixed flexion deformities at the time   of TKA, and be vigilant in the post-operative course to maintain   the correction. Surgical techniques to address pre-operative flexion contractures   include: adequate bone resection, ligament releases, removal of   posterior osteophytes, and posterior capsular releases. Post-operatively,   extension can be maintained with focused physiotherapy, a specially   modified continuous passive motion machine, a contralateral heel   lift, and splinting.
authors.affiliation: Hospital for Special Surgery, 535 East 70th Street, New York, New York 10021, USA. sue@hss.edu
authors.forename: E P
authors.initials: EP
authors.lastname: Su
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000534:rehabilitation; D003286:Contracture / Q000209:etiology / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D020370:Osteoarthritis, Knee / Q000150:complications / Q000534:rehabilitation / Q000601:surgery*; D026741:Physical Therapy Modalities; D011182:Postoperative Care / Q000379:methods; D012307:Risk Factors