Bone resection and ligament treatment for flexion contracture in knee arthroplasty

William Mihalko, Leo A. Whiteside

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

A retrospective study of 103 knees (88 patients) who had primary total knee arthroplasty with a flexion contracture ranging from 20° to 60° was done to tabulate the primary soft tissue structures released during surgery and to identify any residual deformity. The average flexion contracture preoperatively was 27.1° ± 8° and postoperatively was 2.7° ± 3.4° (range, 0°-10°). The average followup was 70.4 months (range, 12-180 months). Only medial or lateral soft tissue balancing procedures were necessary to correct the flexion contracture in 37 knees (35.9%) and no medial or lateral release was necessary in 25 knees (24.3%), of which 16 had a balanced posterior cruciate ligament. The posterior capsule was released on the deformity side of the knee in 15 knees (14.6%) and on the opposite side of the deformity in seven knees (6.8%). The posterior cruciate ligament was balanced in 21 knees (20.4%) and was released in four knees (3.9%). For all knees in which the posterior cruciate ligament was released or balanced, it was done for excessive rollback and tightness in flexion and not for flexion contracture management. In two patients (2%) an additional 4 mm of distal femur was resected for a 45° and a 25° flexion contracture. The data suggest that a contracted collateral ligament is the most likely primary structure whose effective release allows correction of the flexion contracture in most cases.

Original languageEnglish (US)
Pages (from-to)141-147
Number of pages7
JournalClinical Orthopaedics and Related Research
Issue number406
DOIs
StatePublished - Jan 1 2003
Externally publishedYes

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Knee Replacement Arthroplasties
Contracture
Ligaments
Knee
Bone and Bones
Posterior Cruciate Ligament
Therapeutics
Collateral Ligaments
Femur
Capsules
Retrospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Bone resection and ligament treatment for flexion contracture in knee arthroplasty. / Mihalko, William; Whiteside, Leo A.

In: Clinical Orthopaedics and Related Research, No. 406, 01.01.2003, p. 141-147.

Research output: Contribution to journalArticle

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