Abstract
Purpose
The purpose of this study is to evaluate stiff knees which have a preoperative arc of motion (AOM) < 65 degrees and maximum flexion < 90 degrees under anesthesia for primary TKA.
Material and Methods
We prospectively evaluated 25 knees, 20 patients, the follow up period was 5±3 years, OA 13, RA 10 and traumatic OA 2 knees. All case were medial para-patella approaches and snip was added in one knee operation, 23 PS-type and 2 constrain-type TKAs.
Results
Preoperative and postoperative FTA were 185.3±8.4 and 174.2±2.8 degrees, α95.5±3.0, β88.6±2.1, γ4.1±2.9, σ83.8±3.0, CTA1.4±1.9 degrees. Soft tissue releases were performed in Clayton stage I 9, II 14 and III 2 knees, and additional resection for the posterior capsule 11, vastus intermedius 2 and ITT 4 knees and lateral release 4 knees. Additional bone cuts were performed in 19 knees including femur 14 knees and tibia 12 knees. Component gaps (20/30/40lb) of medial and lateral were 9.8±0.8/10.8±2.9/12.2±1.9 mm and 11.0±2.1/12.6±2.5/13.6±2.8 mm at 0 degrees, they were 11.4±2.8/13.5±3.6/15.8±4.1 mm and 12.5±2.7/15.1±3.8 /18.0±4.2 mm at 90 degrees. (Figure1) MCL avulsion was in 3 knees. AOMs in preoperative, perioperative, 1-year later and final observation were 45.0±16.5, 110.4±15.5, 110.8±18.4 and 113.4±18.2 degrees. (Figure2) Flexions were72.5±17.7, 104.0±14.0, 104.0±14.0 and 106.5±14.4 degrees. Extensions were −28.3±10.5, −6.0±7.5, −6.0±7.0 and −6.9±7.8 degrees. There were no statistical differences between perioperative and final AOM, flexion and extension, and between OA and RA.
Discussion
AOM improved and remained after the surgeries. We evaluated soft tissue release and component gaps in 25 stiff knees when preoperative arc of motion (AOM) was < 65 degrees and maximum flexion < 90 degrees under anesthesia for primary TKA. There were no statistical differences between perioperative and final AOM, flexion and extension, and between OA and RA.
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