ORIGINAL ARTICLE

HSS Journal

, Volume 6, Issue 2, pp 138-144

High-Flexion Total Knee Replacement: Functional Outcome at One Year

  • Matthew S. HepinstallAffiliated withDepartment of Orthopedic Surgery, Lenox Hill HospitalLenox Hill Hospital Email author 
  • , Amar S. RanawatAffiliated withDepartment of Orthopedic Surgery, Lenox Hill HospitalDepartment of Orthopedic Surgery, Hospital for Special Surgery
  • , Chitranjan S. RanawatAffiliated withDepartment of Orthopedic Surgery, Hospital for Special Surgery

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Implants designed for enhanced flexion offer the prospect of improved function after total knee replacement (TKR). Whereas most studies evaluating these implants have focused on the range of knee flexion achieved, this study investigated the quality of function in deep knee flexion. The influences of residual pain and maximum flexion angle on function in deep knee flexion were also examined. Eighty-three patients (100 knees) were prospectively followed for 1 year after TKR with a rotating-platform posterior-stabilized high-flexion prosthesis. Range of motion was measured and Knee Society scores were calculated. A questionnaire evaluated residual knee pain and function in high-flexion activities. Mean Knee Society score was 95, and mean knee flexion was 125°, yet 20% of patients could neither kneel, nor squat, nor sit on their heels. Fifty-seven percent were able to kneel without significant difficulty; 69% were able to squat without significant difficulty; and 46% were able to sit on their heels without significant difficulty. Function in deep flexion correlated with pain scores but did not correlate with knee flexion angles or Knee Society scores. Results 1 year after TKR with a rotating-platform posterior-stabilized high-flexion prosthesis are encouraging, but one in five patients remain significantly limited in high-flexion activities.

Keywords

functional outcome high flexion mobile bearing patient satisfaction rotating platform total knee arthroplasty