Published online Feb 28, 2007.
https://doi.org/10.4055/jkoa.2007.42.1.64
Range of Motion after High-Flexion Posterior Stabilized Total Knee Arthroplasty - Minimum 3-year Follow Up -
Abstract
Purpose
The purpose of this prospective study was to determine the factors that can be used to predict the postoperative range of motion, and to evaluate the short-term clinical results after total knee arthroplasty (Superflex™, Stryker Howmedica Osteonics, Allendale, NJ, USA).
Materials and Methods
A total of 69 patients (98 knees) were included in this study. The same surgeon performed all the procedures between April 2002 and December 2002. The patients age ranged from 53 to 81 years, with an average of 68.1 years. The preoperative and postoperative factors (BMI, preoperative flexion contracture, preoperative ROM, preoperative femoral-tibial angle, postoperative knee score and function score) influencing the ROM were evaluated. The patients were followed up once per 1 month for up to 3 years.
Results
At the last follow-up, the average flexion was 128° (110-145°). Twenty patients could kneel down comfortably. Fifty-two patients could sit cross-legged. The preoperative range of flexion was the most important factor influencing the ROM . The average Knee Society knee score was 96 points (80-100), and the function score was 93.6 points (60-100).
Conclusion
Total knee arthroplasty with high-flexion posterior stabilized total knee prostheses showed an excellent ROM and satisfactory early clinical results. The preoperative range of flexion is the most important factor influencing the range of motion after arthroplasty.
Fig. 1
Cross-section schematic diagram showing the difference between the Scorpio and Superflex tibial inserts. The major difference is the larger posterior radius for the Scorpio™ insert. Note that the Superflex™ has a lower posterior lip.
Fig. 2
(A) Patellar tilt and (B) patella shift were measured from the 45° Merchant view.
Fig. 3
A 67-year old female could flex 145° at the operated left knee (A) and anteroposterior and full flexion lateral X-ray (B).
Fig. 4
The images show that the patient could kneel down comfortably (A) and sit cross-legged (B).
Table 1
Postoperative ROM Changes according to the Follow-up Interval
Table 2
Comparison between the Postoperative ROM and the Factors at the 3-year Follow-up (Multiple Regression Analysis Test)
Table 3
Comparison between the Normal Group and Lateral Tilting Group in the Patella (Nonparametric t-test)
Table 4
Comparison between Normal Group and Lateral Subluxation Group in the Patella (Nonparametric t-test)
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