Influence of intra-operative parameters on postoperative early recovery of active knee flexion in posterior-stabilized total knee arthroplasty

Abstract

Active knee flexion is more important for daily activities than passive knee flexion. The hypothesis is that the intra-operative parameters such as osteotomized bone thickness and soft tissue balance affect the postoperative active flexion angle in total knee arthroplasty (TKA). Therefore, we evaluate the influence of intra-operative parameters on postoperative early recovery of active flexion after posterior-stabilized (PS) TKA. The subjects were 45 osteoarthritic knees undergoing primary PS TKA with anterior-reference technique. Intra-operative soft tissue balance was measured using an offset type tensor, and each osteotomized bone thickness was also measured. Pre- and postoperative active knee flexion angles were measured using lateral radiographs. Liner regression analysis was used to determine the influence of these intra-operative parameters on postoperative active flexion angles or recovery of active flexion angles. Pre-operative flexion angle was positively correlated with postoperative flexion angle (R = 0.52, P = 0.0002). Postoperative flexion angle was negatively correlated with the osteotomized bone thickness of femoral medial posterior condyle (R = −0.37, P = 0.012), and femoral lateral posterior condyle (R = −0.36, P = 0.015). Recovery of flexion angle was slightly negatively correlated with gap difference calculated by subtracting joint gap at extension from that at flexion between osteotomized surfaces (R = −0.30, P = 0.046). The osteotomized bone thickness of the femoral posterior condyle is a significant independent factor of postoperative flexion angles. This indicates that the restoration of the posterior condyle offset may lead to larger postoperative active flexion angles in PS TKA.

DOI: 10.1007/s00264-013-2018-y

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@article{Nagai2013InfluenceOI, title={Influence of intra-operative parameters on postoperative early recovery of active knee flexion in posterior-stabilized total knee arthroplasty}, author={Kanto Nagai and Hirotsugu Muratsu and Tomoyuki Matsumoto and Akihiro Maruo and Hidetoshi Miya and Ryosuke Kuroda and Masahiro Kurosaka}, journal={International Orthopaedics}, year={2013}, volume={37}, pages={2153-2157} }