Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty
Abstract Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion–extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and ad...
Gespeichert in:
| Veröffentlicht in: | The Journal of arthroplasty 2013-04, Vol.28 (4), p.585-590 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 590 |
|---|---|
| container_issue | 4 |
| container_start_page | 585 |
| container_title | The Journal of arthroplasty |
| container_volume | 28 |
| creator | Koh, In Jun, MD Chang, Chong Bum, MD, PhD Kang, Yeon Gwi, MS Seong, Sang Cheol, MD, PhD Kim, Tae Kyun, MD, PhD |
| description | Abstract Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion–extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and additional distal femur resection, and determine the polyethylene insert thickness based on flexion–extension gap difference to avoid postoperative FC and flexion instability. We retrospectively reviewed 911 TKAs performed with this protocol to determine the incidence, predictors and effects of postoperative FC on clinical outcomes. Knees with postoperative FC ≥ 10° were identified, and their clinical outcomes were compared with knees without FC. The average follow-up period was 35 months (range, 24–72 months). Eighteen (2.0%) of the 911 knees presented with postoperative FC. The occurrence of postoperative FC was associated with preoperative FC and anterior knee pain, but not with a flexion–extension gap mismatch. A mild to moderate postoperative FC does not increase pain, but may be detrimental to quality of life. |
| doi_str_mv | 10.1016/j.arth.2012.07.014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1317856401</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0883540312005414</els_id><sourcerecordid>1317856401</sourcerecordid><originalsourceid>FETCH-LOGICAL-c477t-90992eab24058a5162b3494e936107934d4908e3109104e9be3ef12867e208263</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxS0EokvhC3BAPnJowozt_JMQUrVqoaJSEZSz5XUmwks2XmwHdb89Drtw4MBpNOP3nsa_YewlQomA9ZttaUL6VgpAUUJTAqpHbIWVFEWroH7MVtC2sqgUyDP2LMYtAGJVqafsTEhUQqlmxcLNZF1Pk6UL_ilQ72zyIV5wM_X8ahjIpsj9wD9TdP1sRn490oPzE1_7KQVj0xyIL-3oJmfz-92crN_Rb9O9T3nycSLil3nR4PejienwnD0ZzBjpxames6_XV_frD8Xt3fub9eVtYVXTpKKDrhNkNkJB1ZoKa7GRqlPUyRqh6aTqVQctSYQOIY83JGlA0dYNCWhFLc_Z62PuPvgfM8Wkdy5aGkczkZ-jRolNW9UKMEvFUWqDjzHQoPfB7Uw4aAS9sNZbvbDWC2sNjc6ss-nVKX_e7Kj_a_kDNwveHgWUf_nTUdDRugV170IGq3vv_p__7h-7PVH-TgeKWz-HKfPTqGP26C_LtZdjowCoVA74BUzbo2M</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1317856401</pqid></control><display><type>article</type><title>Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Koh, In Jun, MD ; Chang, Chong Bum, MD, PhD ; Kang, Yeon Gwi, MS ; Seong, Sang Cheol, MD, PhD ; Kim, Tae Kyun, MD, PhD</creator><creatorcontrib>Koh, In Jun, MD ; Chang, Chong Bum, MD, PhD ; Kang, Yeon Gwi, MS ; Seong, Sang Cheol, MD, PhD ; Kim, Tae Kyun, MD, PhD</creatorcontrib><description>Abstract Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion–extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and additional distal femur resection, and determine the polyethylene insert thickness based on flexion–extension gap difference to avoid postoperative FC and flexion instability. We retrospectively reviewed 911 TKAs performed with this protocol to determine the incidence, predictors and effects of postoperative FC on clinical outcomes. Knees with postoperative FC ≥ 10° were identified, and their clinical outcomes were compared with knees without FC. The average follow-up period was 35 months (range, 24–72 months). Eighteen (2.0%) of the 911 knees presented with postoperative FC. The occurrence of postoperative FC was associated with preoperative FC and anterior knee pain, but not with a flexion–extension gap mismatch. A mild to moderate postoperative FC does not increase pain, but may be detrimental to quality of life.</description><identifier>ISSN: 0883-5403</identifier><identifier>EISSN: 1532-8406</identifier><identifier>DOI: 10.1016/j.arth.2012.07.014</identifier><identifier>PMID: 23142447</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; clinical outcomes ; Contracture - epidemiology ; Contracture - etiology ; Female ; flexion contracture ; Humans ; Incidence ; Male ; Middle Aged ; Orthopedics ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; predictors ; Prognosis ; Retrospective Studies ; total knee arthroplasty ; Treatment Outcome</subject><ispartof>The Journal of arthroplasty, 2013-04, Vol.28 (4), p.585-590</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-90992eab24058a5162b3494e936107934d4908e3109104e9be3ef12867e208263</citedby><cites>FETCH-LOGICAL-c477t-90992eab24058a5162b3494e936107934d4908e3109104e9be3ef12867e208263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883540312005414$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23142447$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koh, In Jun, MD</creatorcontrib><creatorcontrib>Chang, Chong Bum, MD, PhD</creatorcontrib><creatorcontrib>Kang, Yeon Gwi, MS</creatorcontrib><creatorcontrib>Seong, Sang Cheol, MD, PhD</creatorcontrib><creatorcontrib>Kim, Tae Kyun, MD, PhD</creatorcontrib><title>Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty</title><title>The Journal of arthroplasty</title><addtitle>J Arthroplasty</addtitle><description>Abstract Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion–extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and additional distal femur resection, and determine the polyethylene insert thickness based on flexion–extension gap difference to avoid postoperative FC and flexion instability. We retrospectively reviewed 911 TKAs performed with this protocol to determine the incidence, predictors and effects of postoperative FC on clinical outcomes. Knees with postoperative FC ≥ 10° were identified, and their clinical outcomes were compared with knees without FC. The average follow-up period was 35 months (range, 24–72 months). Eighteen (2.0%) of the 911 knees presented with postoperative FC. The occurrence of postoperative FC was associated with preoperative FC and anterior knee pain, but not with a flexion–extension gap mismatch. A mild to moderate postoperative FC does not increase pain, but may be detrimental to quality of life.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arthroplasty, Replacement, Knee</subject><subject>clinical outcomes</subject><subject>Contracture - epidemiology</subject><subject>Contracture - etiology</subject><subject>Female</subject><subject>flexion contracture</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Orthopedics</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>predictors</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>total knee arthroplasty</subject><subject>Treatment Outcome</subject><issn>0883-5403</issn><issn>1532-8406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EokvhC3BAPnJowozt_JMQUrVqoaJSEZSz5XUmwks2XmwHdb89Drtw4MBpNOP3nsa_YewlQomA9ZttaUL6VgpAUUJTAqpHbIWVFEWroH7MVtC2sqgUyDP2LMYtAGJVqafsTEhUQqlmxcLNZF1Pk6UL_ilQ72zyIV5wM_X8ahjIpsj9wD9TdP1sRn490oPzE1_7KQVj0xyIL-3oJmfz-92crN_Rb9O9T3nycSLil3nR4PejienwnD0ZzBjpxames6_XV_frD8Xt3fub9eVtYVXTpKKDrhNkNkJB1ZoKa7GRqlPUyRqh6aTqVQctSYQOIY83JGlA0dYNCWhFLc_Z62PuPvgfM8Wkdy5aGkczkZ-jRolNW9UKMEvFUWqDjzHQoPfB7Uw4aAS9sNZbvbDWC2sNjc6ss-nVKX_e7Kj_a_kDNwveHgWUf_nTUdDRugV170IGq3vv_p__7h-7PVH-TgeKWz-HKfPTqGP26C_LtZdjowCoVA74BUzbo2M</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Koh, In Jun, MD</creator><creator>Chang, Chong Bum, MD, PhD</creator><creator>Kang, Yeon Gwi, MS</creator><creator>Seong, Sang Cheol, MD, PhD</creator><creator>Kim, Tae Kyun, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty</title><author>Koh, In Jun, MD ; Chang, Chong Bum, MD, PhD ; Kang, Yeon Gwi, MS ; Seong, Sang Cheol, MD, PhD ; Kim, Tae Kyun, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-90992eab24058a5162b3494e936107934d4908e3109104e9be3ef12867e208263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arthroplasty, Replacement, Knee</topic><topic>clinical outcomes</topic><topic>Contracture - epidemiology</topic><topic>Contracture - etiology</topic><topic>Female</topic><topic>flexion contracture</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Orthopedics</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>predictors</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>total knee arthroplasty</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koh, In Jun, MD</creatorcontrib><creatorcontrib>Chang, Chong Bum, MD, PhD</creatorcontrib><creatorcontrib>Kang, Yeon Gwi, MS</creatorcontrib><creatorcontrib>Seong, Sang Cheol, MD, PhD</creatorcontrib><creatorcontrib>Kim, Tae Kyun, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of arthroplasty</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koh, In Jun, MD</au><au>Chang, Chong Bum, MD, PhD</au><au>Kang, Yeon Gwi, MS</au><au>Seong, Sang Cheol, MD, PhD</au><au>Kim, Tae Kyun, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty</atitle><jtitle>The Journal of arthroplasty</jtitle><addtitle>J Arthroplasty</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>28</volume><issue>4</issue><spage>585</spage><epage>590</epage><pages>585-590</pages><issn>0883-5403</issn><eissn>1532-8406</eissn><abstract>Abstract Patients who present with large flexion contracture (FC) but have well maintained maximum flexion tend to have a flexion–extension gap mismatch, which can cause residual FC or flexion instability after TKA. We routinely use posterior-stabilized implants, perform soft tissue balancing and additional distal femur resection, and determine the polyethylene insert thickness based on flexion–extension gap difference to avoid postoperative FC and flexion instability. We retrospectively reviewed 911 TKAs performed with this protocol to determine the incidence, predictors and effects of postoperative FC on clinical outcomes. Knees with postoperative FC ≥ 10° were identified, and their clinical outcomes were compared with knees without FC. The average follow-up period was 35 months (range, 24–72 months). Eighteen (2.0%) of the 911 knees presented with postoperative FC. The occurrence of postoperative FC was associated with preoperative FC and anterior knee pain, but not with a flexion–extension gap mismatch. A mild to moderate postoperative FC does not increase pain, but may be detrimental to quality of life.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23142447</pmid><doi>10.1016/j.arth.2012.07.014</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0883-5403 |
| ispartof | The Journal of arthroplasty, 2013-04, Vol.28 (4), p.585-590 |
| issn | 0883-5403 1532-8406 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1317856401 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged Aged, 80 and over Arthroplasty, Replacement, Knee clinical outcomes Contracture - epidemiology Contracture - etiology Female flexion contracture Humans Incidence Male Middle Aged Orthopedics Postoperative Complications - epidemiology Postoperative Complications - etiology predictors Prognosis Retrospective Studies total knee arthroplasty Treatment Outcome |
| title | Incidence, Predictors, and Effects of Residual Flexion Contracture on Clinical Outcomes of Total Knee Arthroplasty |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T18%3A42%3A38IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incidence,%20Predictors,%20and%20Effects%20of%20Residual%20Flexion%20Contracture%20on%20Clinical%20Outcomes%20of%20Total%20Knee%20Arthroplasty&rft.jtitle=The%20Journal%20of%20arthroplasty&rft.au=Koh,%20In%20Jun,%20MD&rft.date=2013-04-01&rft.volume=28&rft.issue=4&rft.spage=585&rft.epage=590&rft.pages=585-590&rft.issn=0883-5403&rft.eissn=1532-8406&rft_id=info:doi/10.1016/j.arth.2012.07.014&rft_dat=%3Cproquest_cross%3E1317856401%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1317856401&rft_id=info:pmid/23142447&rft_els_id=S0883540312005414&rfr_iscdi=true |