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Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts

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Abstract

It is debatable whether high-flexion (HF) total knee arthroplasty (TKA) designs will improve postoperative flexion and function or will diminish the need for manipulation under anaesthesia (MUA). We retrospectively analysed range of motion (ROM), flexion, Knee Society Score (KSS), and rate of MUA in a consecutive group of patients who underwent TKA with a conventional posterior stabilised (PS) insert or an HF insert using identical surgical technique, implant design, and postoperative care. Fifty TKAs with a standard PS insert were matched for patient’s age, gender, preoperative ROM, and KSS with 50 TKA performed with an HF insert. The patient’s ROM and KSS were evaluated at six weeks, four months, and one year postoperatively. The outcome variables (flexion, ROM, KSS, and manipulation rate) in both groups were compared using the generalised estimating equations method. A second analysis of patients with preoperative flexion ≥120° was performed. The ROM, flexion, and patient-reported KSS was similar in both groups at each time period. The rate of MUA was also similar. Patients with a preoperative ROM of at least 120° showed similar results. Our study found that one year after surgery, patients who underwent TKA with a PS or an HF insert achieved similar flexion, ROM, and function.

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Acknowledgements

We are grateful to Mrs. Victoria Bidwell, Mr. Richard Sorgini, the Eleanor Jennings Myatt Memorial Fund, Dr. Eduardo Salvati and Dr. Thomas Sculco who provided funding for this study. We are grateful to Dr. Stephen Haas for his collaboration in the description of the high-flexion implant design used in our study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA

    Aamer Malik, Judith Ben Ari & Alejandro González Della Valle

  2. Weill Medical College of Cornell University, New York, NY, USA

    Aamer Malik, Judith Ben Ari & Alejandro González Della Valle

  3. Department of Public Health, Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA

    Yan Ma

  4. Hospital of Orthopedics and Traumatology No. 21, Monterrey, Mexico

    Antonio Salas

  5. Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Alejandro González Della Valle

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  1. Aamer Malik
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  2. Antonio Salas
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  3. Judith Ben Ari
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  4. Yan Ma
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  5. Alejandro González Della Valle
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Correspondence to Alejandro González Della Valle.

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Malik, A., Salas, A., Ben Ari, J. et al. Range of motion and function are similar in patients undergoing TKA with posterior stabilised and high-flexion inserts. International Orthopaedics (SICOT) 34, 965–972 (2010). https://doi.org/10.1007/s00264-009-0865-3

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  • DOI: https://doi.org/10.1007/s00264-009-0865-3

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