Determinants of range of motion in cruciate retaining total knee arthroplasty: a prospective study

Background: Total knee replacement (TKR) is to provide a stable painless knee with adequate range of motion (ROM) for daily activities. The aim of the study is to evaluate various factors that influence ROM in cruciate retaining TKR postoperatively.Methods: Fourty four patients with osteoarthritis knee treated in our institute with TKR using cruciate retaining prosthesis are included in study and analysed prospectively. Mean follow up was 6 months. Patients are analyzed for following factors–age, gender, BMI, preoperative ROM, changes in posterior femoral condylar offset, posterior tibial slope after surgery. Statistical analysis of effect of all factors on knee ROM was done. Assessment was done preoperatively and 3 and 6 months postoperatively.Results: Gender did not affect the final ROM. Mean age of patients is 65. Age has negative correlation with ROM (p=-0.45). The mean knee range improved from 92˚ to 101˚. Factors that negatively affect ROM include, BMI (p=-0.04) and Preoperative flexion deformity (p=-0.03). Factors that positively affect ROM include, knee scores and good preoperative flexion (p=0.001). Males have good amount of flexion preoperatively and post operatively when compared to females.Conclusions: Preoperative ROM, flexion contracture and BMI are the important factors affecting the range of motion in total knee arthroplasty. Proper counselling of patient preoperatively regarding these various factors and appropriate selection of patient is of utmost important for satisfactory functional outcome.

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Factors affecting range of motion in total knee arthroplasty using high flexion prosthesis: A prospective study

Indian Journal of Orthopaedics ◽

10.4103/0019-5413.106901 ◽

2013 ◽

Vol 47 (1) ◽

pp. 50 ◽

Cited By ~ 13

Author(s):

AshokK Shyam ◽

Rajeev Joshi ◽

Kailash Patil ◽

Anubhav Jain ◽

KantilalH Sancheti ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Prospective Study ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Factors Affecting ◽

High Flexion ◽

Total Knee ◽

A Prospective Study

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Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0041-1729967 ◽

2021 ◽

Author(s):

O-Sung Lee ◽

Jangyun Lee ◽

Myung Chul Lee ◽

Hyuk-Soo Han

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Correlation Coefficient ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Posterior Tibial ◽

Clinical Scores ◽

Total Knee ◽

The Mean

AbstractThe posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ± 3.4 and 120.1 ± 15.4 degrees preoperatively to 2.0 ± 1.3 and 128.4 ± 9.3 degrees postoperatively, and the mean PTS change was 7.6 ± 3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

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Factors Affecting Postoperative Range of Motion After Total Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0030-1248221 ◽

2010 ◽

Vol 17 (04) ◽

pp. 196-202 ◽

Cited By ~ 71

Author(s):

Nehal Gatha ◽

Henry Clarke ◽

Robin Fuchs ◽

Giles Scuderi ◽

John Insall

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Factors Affecting ◽

Total Knee

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Influence of Posterior Tibial Slope on Kinematics After Cruciate-Retaining Total Knee Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.07.029 ◽

2018 ◽

Vol 33 (12) ◽

pp. 3778-3782.e1 ◽

Cited By ~ 4

Author(s):

Toshitaka Fujito ◽

Tetsuya Tomita ◽

Takaharu Yamazaki ◽

Kosaku Oda ◽

Hideki Yoshikawa ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Cruciate Retaining ◽

Posterior Tibial ◽

Total Knee

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Reproducing the Native Posterior Tibial Slope in Cruciate-Retaining Total Knee Arthroplasty: Technique and Clinical Implications

Orthopedics ◽

10.3928/01477447-20191122-06 ◽

2019 ◽

Vol 43 (1) ◽

pp. e21-e26

Author(s):

James L. Howard ◽

Mina W. Morcos ◽

Brent A. Lanting ◽

Lyndsay E. Somerville ◽

James P. McAuley

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Clinical Implications ◽

Cruciate Retaining ◽

Posterior Tibial ◽

Total Knee

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Posterior tibial slope and femoral sizing affect posterior cruciate ligament tension in posterior cruciate-retaining total knee arthroplasty

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2015.05.006 ◽

2015 ◽

Vol 30 (7) ◽

pp. 676-681 ◽

Cited By ~ 11

Author(s):

Shinichi Kuriyama ◽

Masahiro Ishikawa ◽

Shinichiro Nakamura ◽

Moritoshi Furu ◽

Hiromu Ito ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Posterior Cruciate Ligament ◽

Knee Arthroplasty ◽

Cruciate Ligament ◽

Tibial Slope ◽

Posterior Tibial Slope ◽

Cruciate Retaining ◽

Posterior Tibial ◽

Ligament Tension ◽

Total Knee

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Range of Motion in Total Knee Arthroplasty: A Prospective Comparison of High-Flexion and Standard Cruciate-Retaining Designs

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.h.00300 ◽

2009 ◽

Vol 91 (3) ◽

pp. 672-679 ◽

Cited By ~ 41

Author(s):

Jong Keun Seon ◽

Sang Jin Park ◽

Keun Bae Lee ◽

Taek Rim Yoon ◽

Michal Kozanek ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Cruciate Retaining ◽

High Flexion ◽

Prospective Comparison ◽

Total Knee

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Cruciate Retaining compared with Posterior Stabilised Nexgen total knee arthroplasty: results at 10 years in a matched cohort

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0086 ◽

2017 ◽

Vol 99 (8) ◽

pp. 602-606 ◽

Cited By ~ 4

Author(s):

AIW Mayne ◽

HP Harshavardhan ◽

LR Johnston ◽

W Wang ◽

A Jariwala

Keyword(s):

Total Knee Arthroplasty ◽

Patient Satisfaction ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Functional Score ◽

Range Of Movement ◽

Cruciate Retaining ◽

Score Improvement ◽

Total Knee

INTRODUCTION Debate has persisted for many years about whether to sacrifice or replace the posterior cruciate ligament when performing total knee arthroplasty. A paucity of long-term follow-up studies comparing outcomes between cruciate-retaining and posterior-stabilised knees exist. We aimed to compare results at ten-year follow-up. METHODS A matched paired study comparing a cohort of 107 Zimmer Nexgen® Cruciate Retaining (CR) patients with a cohort of 107 Nexgen Posterior-Stabilised (PS) knees matched for age, sex, body mass index and preoperative American Knee Society score was undertaken. All patients underwent independent clinical assessment and knee society scoring preoperatively and at 1, 3, 5, 7 and 10 years postoperatively. RESULTS Fifty-three patients (49.5%) in the CR group and 44 patients (41.1%) in the PS group were alive at 10-year follow-up. There were no significant differences between the CR and PS groups with regards to functional assessment (P = 0.95), overall range of movement (P = 0.46) or patient satisfaction (P = 1.0) at 10 years. However, there was a significantly better score improvement in range of movement in PS knees compared with CR knees (P = 0.027). There were six revisions (5.6%) in the PS group and 1 (0.93%) in the CR group (P = 0.12). Both CR and PS knees showed excellent survivorship with no significant difference at 10 years (P = 0.068). CONCLUSIONS There were no significant differences in functional score, overall range of motion or patient satisfaction between the Nexgen cruciate retaining and posterior stabilised total knee arthroplasty at 10-year follow-up. However, PS knees had a greater score improvement in range of motion compared with CR knees.

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