The Relationship between Pre- and Postoperative Range of Motion Utilizing Three Cruciate-Retaining Total Knee Prostheses

Abstract

We prospectively examined the relationship between pre- and postoperative range of motion utilizing three cruciate retaining knees with various mechanical flexion potentials, i.e., two at about 130 degrees -135 degrees (one with posterior lip and the other without) and the third at about 140 degrees -145 degrees . All groups demonstrated mean flexion and range of motion of 116 degrees -122 degrees at one year. Combining data from the three cohorts, patients with the following preoperative flexion values achieved the indicated mean changes (increases) in flexion at one year: < 90 degrees flexion (Delta 23.6 degrees ), 91 degrees -105 degrees flexion (Delta 19.3 degrees ), and > 105 degrees flexion (Delta 1.8 degrees )). Postoperative improvement was inversely related to preoperative flexion. The high flex knee yielded the best improvement in range of motion (9.7 degrees increase) in the highest flex preoperative group compared to that of the other knees (-7.4 degrees to 2.9 degrees ). Hence, a high flex knee design seems to be important in high preoperative range of motion patients obtaining an increase in the postoperative range of motion rather than possible regression.

Total Knee Arthroplasty in Asian Subjects: Preoperative Range of Motion Determines Postoperative Range of Motion?

“…In answer to our second question, we found that Asian patients with poorer preoperative ROM gained more flexion than their counterparts with better preoperative ROM, who lost flexion following TKA. Similar findings have been reported by several Western studies. In a landmark study conducted by Parsley et al ., 313 posterior‐cruciate‐retaining TKAs were assessed to determine the influence of preoperative ROM on postoperative ROM.…”

Clinical Outcomes in Men and Women following Total Knee Arthroplasty with a High‐Flex Knee: No Clinical Effect of Gender

“…In general, the change in motion following TKA is inversely related to the preoperative value, that is, patients presenting with restricted motion tend to gain much motion after surgery while those with a high degree of motion initially tend to stay about the same, or perhaps lose a small amount of motion, after surgery [ 20 , 23 ]. While this “regression toward the mean” is well documented, a potential gender effect has not been previously investigated.…”

“…The Vanguard knee (Biomet, Warsaw, IN) is a high-flex design as it can mechanically accommodate up to 145° of flexion although that achieved clinically may be less due to the soft tissue restraint of the patient [ 20 , 23 ]. From September 2004 to April 2013, a consecutive series of 1,328 patients received 1,785 cruciate-retaining (CR) knees of this type via a medial parapatellar approach using cemented fixation, including 802 women (1,069 knees) and 526 men (716 knees).…”

Gender comparison of clinical outcomes post high-flex total knee arthroplasty

“…The high flex CR knee utilized for addressing the issue was selected, to some degree, because there has been big cohort, mid-term studies published recently on present framework to give a standard to which our outcomes might be analysed [20,28]. [20,23,29].…”

“…We hypothesized that there would be no gender difference in those measurements. [20,23]. All the patella was resurfaced.…”