Clinical outcome of increased flexion gap after to

Authors: P Ismailidis M S Kuster B Jost K Giesinger H Behrend

Publish Date: 2016/02/04

Volume: 25, Issue: 6, Pages: 1705-1711

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Abstract

Increased range of motion ROM while maintaining joint stability is the goal of modern total knee arthroplasty TKA A biomechanical study has shown that small increases in flexion gap result in decreased tibiofemoral force beyond 90° flexion The purpose of this paper was to investigate clinical implications of controlled increased flexion gapFour hundred and four TKAs were allocated into one of two groups and analysed retrospectively In the first group n = 352 flexion gap exceeded extension gap by 25 mm while in the second group n = 52 flexion gap was equal to the extension gap The procedures were performed from 2008 to 2012 The patients were reviewed 12 months postoperatively Objective clinical results were assessed for ROM mediolateral and sagittal stability Patientreported outcome measures were the WOMAC score and the Forgotten Joint Score FJS12After categorizing postoperative flexion into three groups poor  90° satisfactory 91°–119° good ≥ 120° significantly more patients in group 1 achieved satisfactory or good ROM p = 0006 Group 1 also showed a significantly higher mean FJS12 group 1 73 group 2 61 p = 002 The mean WOMAC score was 11 in the first and 14 in the second group ns Increase in flexion gap did not influence knee stabilityThe clinical relevance of this study is that a controlled flexion gap increase of 25 mm may have a positive effect on postoperative flexion and patient satisfaction after TKA Neither knee stability in the coronal and sagittal planes nor complications were influenced by a controlled increase in flexion gap

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