Extension Contracture Post Total Knee Replacement: A Case Report

BACKGROUND: Stiffness is a common problem after knee arthroplasty and need for further procedure. Patients who experience this problem usually have poor outcome. Flexion contracture is the most reported case in most case reports; however, we reported a rare case of patient with extension contracture after total knee arthroplasty (TKA). CASE REPORT: A 62-year-old woman was presented with a 3-month history of right TKA. After 3 month she came to the hospital and complained that she could not flex the knee. Nevertheless, she could still walk. On the right knee, there was quadriceps hypotrophy. There was no active and passive range of motion (ROM), because it was fixed at 0°. We performed medial parapatellar approach for knee arthrotomy and we added lateral parapatellar arthrotomy to release the contracture. The fibrotic tissues were removed. The flexion and extension of the knee were evaluated and we managed to get 0–130° of flexion-extension ROM. In the ward, the patient was treated using continuous passive motion (CPM) for 1 week and the CPM was maintained within the range of 0–130°. Six months after surgery, the patient could walk normal with ROM range between 0 and 100°. CONCLUSION: Stiff knee is a common problem after TKA. Close observation and proper rehabilitation can prevent stiff knee. Close manipulation, manipulation under anesthesia, arthroscopy debridement, and open contracture release are the option of this problem.

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Continuous Passive Motion Not Affect the Knee Motion and the Surgical wound Aspect After Total Knee Arthroplasty

10.21203/rs.3.rs-1060396/v1 ◽

2021 ◽

Author(s):

Sergi Gil-Gonzalez ◽

Ricardo Andrés Barja Rodriguez ◽

Antoni Lopez Pujol ◽

Hussein Berjaoui ◽

Jose Enrique Fernandez Bengoa ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Continuous Passive Motion ◽

Surgical Wound ◽

Knee Motion ◽

Passive Motion ◽

Significant Difference ◽

Flexion Extension ◽

Total Knee

Abstract Background. This study aimed to assess whether use of continuous passive motion (CPM) can improve range of motion in patients after total knee arthroplasty (TKA). Moreover, the relationship between the use of CPM with the surgical wound aspect (SWA) and pain management after TKA was analysed.Methods. We randomized 210 patients, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain was measured before surgery, on the 1s, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 hours after surgery. This scale analyses swelling, erythema, haematoma, blood drainage and blisters. Results. There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for haematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions. The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in haematoma appearance.

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Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report

Cases Journal ◽

10.1186/1757-1626-1-421 ◽

2008 ◽

Vol 1 (1) ◽

Cited By ~ 15

Author(s):

Eric Finger ◽

F Buck Willis

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Knee Arthroplasty ◽

Knee Flexion ◽

Flexion Contracture ◽

Knee Flexion Contracture ◽

Dynamic Splinting ◽

Total Knee

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Continuous passive motion not affect the knee motion and the surgical wound aspect after total knee arthroplasty

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-022-02916-w ◽

2022 ◽

Vol 17 (1) ◽

Author(s):

Sergi Gil-González ◽

Ricardo Andrés Barja-Rodríguez ◽

Antoni López-Pujol ◽

Hussein Berjaoui ◽

Jose Enrique Fernández-Bengoa ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Range Of Motion ◽

Knee Arthroplasty ◽

Continuous Passive Motion ◽

Surgical Wound ◽

Knee Motion ◽

Passive Motion ◽

Significant Difference ◽

Flexion Extension ◽

Total Knee

Abstract Background This study aimed to assess whether use of continuous passive motion (CPM) could improve range of motion in patients after total knee arthroplasty (TKA), if it could affect the surgical wound aspect (SWA) and if it could influence on pain management after TKA. Methods We randomized 210 patients in two groups, 102 patients in the CPM group, who received a standard rehabilitation protocol together with CPM application; and 108 patients in the no-CPM group, without CPM. Variables as knee motion (flexion, extension, range of motion) and pain were measured before surgery, on the 1st, 2nd and 3rd postoperative day, and in the 2nd, 6th, 12th and 24th postoperative weeks following TKA. The SWA was determined by the “surgical wound aspect score” (SWAS) in the next 48 h after surgery. This scale analyzes swelling, erythema, hematoma, blood drainage and blisters. Results There was an improvement in the knee motion over the course of follow-up in both groups, without significant difference in flexion parameter. We found no significant differences in the total score of SWA, except for hematoma, with less severity in the CPM group. Furthermore, we found no differences in the others SWAS parameters and pain. Conclusions The application of CPM does not provide benefit to our patients undergoing TKA in terms of either improved flexion mobility or decreased pain. No relationship was found between the use of CPM and the global score of SWA following a TKA, except for a decrease in hematoma appearance.

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Neglected Posterior Dislocation Septic Loosening and Prolonged Flexion Contracture of Total Knee Arthroplasty: A Case Report

American Journal of Case Reports ◽

10.12659/ajcr.931857 ◽

2021 ◽

Vol 22 ◽

Author(s):

Vasileios Athanasiou ◽

Andreas Panagopoulos ◽

John Gliatis ◽

Nikolaos Papathanasiou ◽

Minos Tyllianakis ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Knee Arthroplasty ◽

Flexion Contracture ◽

Posterior Dislocation ◽

Septic Loosening ◽

Total Knee

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Anterior tibiofemoral dislocation after total knee arthroplasty: A case report and literature review

Chinese Journal of Traumatology ◽

10.1016/j.cjtee.2021.07.002 ◽

2021 ◽

Author(s):

Alejandro Almoguera-Martinez ◽

Catarina Godinho-Soares ◽

Valentín Calcedo Bernal ◽

José-Antonio Pareja Esteban ◽

Marta Garcia-Lopez ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Literature Review ◽

Knee Arthroplasty ◽

Total Knee

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Intraoperative manipulation for flexion contracture during total knee arthroplasty

Journal of Orthopaedic Surgery ◽

10.1177/2309499019825574 ◽

2019 ◽

Vol 27 (1) ◽

pp. 230949901982557

Author(s):

Yoshio Matsui ◽

Masanori Matsuura ◽

Yukihide Minoda ◽

Sigeru Nakagawa ◽

Yoshiaki Okajima ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Flexion Contracture ◽

Total Knee

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Modifiable and Nonmodifiable Predictive Factors Associated with the Outcomes of Total Knee Arthroplasty

Joints ◽

10.1055/s-0039-1678563 ◽

2019 ◽

Vol 07 (01) ◽

pp. 013-018

Author(s):

Davide E. Bonasia ◽

Anna Palazzolo ◽

Umberto Cottino ◽

Francesco Saccia ◽

Claudio Mazzola ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Prognostic Factors ◽

Treatment Option ◽

Predictive Factors ◽

Knee Arthroplasty ◽

Factors Associated ◽

Modifiable Factors ◽

Valuable Treatment ◽

Total Knee ◽

The Right

AbstractTotal knee arthroplasty (TKA) is a valuable treatment option for advanced osteoarthritis in patients unresponsive to conservative treatments. Despite overall satisfactory results, the rate of unsatisfied patients after TKA remains high, ranging from 5 to 40%. Different modifiable and nonmodifiable prognostic factors associated with TKA outcomes have been described. The correction, whenever possible, of modifiable factors is fundamental in preoperative patients' optimization protocols. Nonmodifiable factors can help in predicting the outcomes and creating the right expectations in the patients undergoing TKA. The goal of this review is to summarize the modifiable and nonmodifiable prognostic factors associated with TKA outcomes.

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Primary total knee arthroplasty with condylar allograft and MCL reconstruction for a comminuted medial condyle fracture in an arthritic knee—a case report

The Knee ◽

10.1016/j.knee.2006.06.006 ◽

2006 ◽

Vol 13 (5) ◽

pp. 400-403 ◽

Cited By ~ 3

Author(s):

Varatharaj Mounasamy ◽

Shen-Ying Ma ◽

Robert J. Schoderbek ◽

William M. Mihalko ◽

Khaled J. Saleh ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Case Report ◽

Knee Arthroplasty ◽

Primary Total Knee Arthroplasty ◽

Medial Condyle ◽

Medial Condyle Fracture ◽

Total Knee ◽

Condyle Fracture ◽

Primary Total Knee ◽

Arthritic Knee

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Bone Cement Solidifiliation Influence the Limb Alignment and Gap Balance during TKA

BioMed Research International ◽

10.1155/2015/109402 ◽

2015 ◽

Vol 2015 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Dongquan Shi ◽

Xingquan Xu ◽

Anyun Guo ◽

Jin Dai ◽

Zhihong Xu ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Bone Cement ◽

Knee Arthroplasty ◽

Mechanical Axis ◽

Statistical Significance ◽

Mechanical Alignment ◽

Early Loosening ◽

Flexion Extension ◽

Before And After ◽

Total Knee

Introduction. Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during fixation of the femoral and tibial component is an essential step in performing a successful total knee arthroplasty. Bone cement is used to solidify the bone and prosthesis. Thickness imbalance of bone cement leads to the deviation of mechanical alignment. To estimate the influence of bone cement, a retrospective study was conducted.Materials and Methods. A total of 36 subjects were studied. All the TKA were performed following the standard surgical protocol for navigated surgery by medial approach with general anaesthesia. Prostheses were fixed by bone cement.Results. We compared the mechanical axis, flexion/extension, and gap balance before and after cementation. All the factors were different compared with those before and after cementation. Internal rotation was reached with statistical significance (P=0.03).Conclusion. Bone cement can influence the mechanical axis, flexion/extension, and gap balance. It also can prompt us to make a change when poor knee kinematics were detected before cementation.

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