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IS FULL FLEXION SAFE AFTER TOTAL KNEE REPLACEMENT



Abstract

At our institution significant number of patients were able to have full movement after TKA; however the concern is whether deep flexion after TKA will increase certain complications or whether it will cause early damage to the knee components.

384 Total knee replacements were performed from January 97 to January2002. Three deferent knee systems were used (IB2, NEXGEN and LPS Flex). Preoperative and post operative range of motion was document on lateral x-ray. Knee score was documented and data was processed at major university in Scotland. All surgeries were performed by a single surgeon. Patient was considered to have full flexion if he is able to flex the knee over 140 and able to kneel with the calf touching the thigh for at least one minute. Post operative x-ray was reviewed at 1 and 2 years.3D images were obtained on selected cases.

216 Cases had full flexion as per above definition and 168 cases failed to achieve full flexion. There was no significant deference in complication rate between patients who had full flexion and those who did not. The complication rates were similar to that reported in other series. X ray review did not show any component damage in the full the flexion group; however two phenomenons were documented in some patient who had full movement: dig in phenomenon and lateral femoral condyle spin off (confirmed on 3D images).

Full flexion after TKA did not increase complication rates. The significance of dig in and spin off phenomenon needs further investigation

Correspondence should be addressed to Richard Komistek, PhD, International Society for Technology in Arthroplasty, PO Box 6564, Auburn, CA 95604, USA. E-mail: ista@pacbell.net