SOFT TISSUE RELEASE AND RANGE OF MOVEMENT FOLLOWING TOTAL KNEE REPLACEMENT

Abstract

Objective: To evaluate the impact of soft tissue release on range of movement following total knee replacement.

Methods: Sixty four patients underwent next-gen (Zimmer) posterior stabilising total knee replacement through a medial arthrotomy. Range of active movement was measured preoperatively, and maximal flex-ion was measured after implantation, using the drop test while the patient was under anaesthetic. Soft tissue release was graded from 1 to 5, depending on the structures released.

Range of movement (ROM) was correlated with extent of soft tissue release, to see if release had any impact on increase in range of movement.

Results: All patients had an improvement in range of movement following surgery. Post operative range of movement correlated strongly with preoperative ROM. Patients requiring extensive releases tended to have less preoperative ROM, but the gain was independent of medial release. Those requiring extensive posterior release had poorer preoperative movement, and significantly less improvement.

In those requiring an extensive medial release, a posterior release improved gain in ROM.

Conclusion: Postoperative ROM following TKR is independent of extent of medial release. In patients requiring extensive medial release, a posterior release improves gain in movement.