Skip to main content

Advertisement

SpringerLink
Log in

Preoperative flexion does not influence postoperative flexion after rotating-platform total knee arthroplasty

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Preoperative range of motion (ROM) has been regarded as one of the most important factors in predicting postoperative ROM following total knee arthroplasty (TKA). Mobile-bearing TKA designs have been suggested to possibly improve the knee kinematics compared to fixed-bearing designs. The purpose of this study was to examine the difference in postoperative flexion as a function of preoperative flexion in a consecutive series of TKAs done using a posterior-stabilized rotating-platform prosthesis.

Methods

ROM was assessed in 153 consecutive TKAs done using a rotating-platform posterior cruciate-substituting design. Patients were divided into two groups based on their preoperative ROM (Group 1 < 95°, Group 2 > 95°). The Knee Society Score (KSS) and ROM were assessed preoperatively, 3 months and 12 months postoperatively.

Results

There was no difference in flexion 12 months after surgery between groups (mean 120° and 123°, respectively. n.s.). After 3 month follow-up, no increase in ROM was experienced by either group. Patients in Group 1 experienced significantly greater increases in both ROM (p < 0.001) and KSS (p < 0.05). There was no difference in the KSS at 12 months after surgery between groups.

Conclusion

In this series of patients undergoing TKA with a rotating-platform prosthesis, the preoperative ROM was not predictive of the postoperative ROM. Patients with stiff knees preoperatively may benefit from a mobile-bearing design prosthesis.

Level of evidence

Case–control study, Level III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Anouchi YS, McShane M, Kelly F Jr, Elting J, Stiehl J (1996) Range of motion in total knee replacement. Clin Orthop Relat Res 331:87–92

    Article  PubMed  Google Scholar 

  2. Ball ST, Sanchez HB, Mahoney OM, Schmalzried TP (2011) Fixed versus rotating platform total knee arthroplasty: a prospective, randomized, single-blind study. J Arthroplasty 26(4):531–536

    Article  PubMed  Google Scholar 

  3. Breugem SJ, Sierevelt IN, Schafroth MU, Blankevoort L, Schaap GR, van Dijk CN (2008) Less anterior knee pain with a mobile-bearing prosthesis compared with a fixed-bearing prosthesis. Clin Orthop Relat Res 466:1959–1965

    Article  PubMed Central  PubMed  Google Scholar 

  4. Delport HP, Banks SA, De Schepper J, Bellemans J (2006) A kinematic comparison of fixed- and mobile-bearing knee replacements. J Bone Joint Surg Br 88(8):1016–1021

    Article  CAS  PubMed  Google Scholar 

  5. Dennis DA, Komistek RD, Stiehl JB, Walker SA, Dennis KN (1998) Range of motion after total knee arthroplasty: the effect of implant design and weight-bearing conditions. J Arthroplasty 13(7):748–752

    Article  CAS  PubMed  Google Scholar 

  6. Dennis DA, Komistek RD (2006) Mobile-bearing total knee arthroplasty: design factors in minimizing wear. Clin Orthop Relat Res 452:70–77

    Article  PubMed  Google Scholar 

  7. Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res 248:9–12

    PubMed  Google Scholar 

  8. Gatha NM, Clarke HD, Fuchs R, Scuderi GR, Insall JN (2004) Factors affecting postoperative range of motion after total knee arthroplasty. J Knee Surg 17(4):196–202

    PubMed  Google Scholar 

  9. Hamelynck KJ (2006) The history of mobile-bearing total knee replacement systems. Orthopedics 29(9 Suppl):S7–S12

    PubMed  Google Scholar 

  10. Harrington MA, Hopkinson WJ, Hsu P, Manion L (2009) Fixed- vs mobile-bearing total knee arthroplasty: does it make a difference?—a prospective randomized study. J Arthroplasty 24(6 Suppl):24–27

    Article  PubMed  Google Scholar 

  11. Hartman CW, Ting NT, Moric M, Berger RA, Rosenberg AG, Della Valle CJ (2010) Revision total knee arthroplasty for stiffness. J Arthroplasty 25(6 Suppl):62–66

    Article  PubMed  Google Scholar 

  12. Harvey IA, Barry K, Kirby SP, Johnson R, Elloy MA (1993) Factors affecting the range of movement of total knee arthroplasty. J Bone Joint Surg Br 75(6):950–955

    CAS  PubMed  Google Scholar 

  13. Hooper G, Rothwell A, Frampton C (2009) The low contact stress mobile-bearing total knee replacement: a prospective study with a minimum follow-up of ten years. J Bone Joint Surg Br 91(1):58–63

    Article  CAS  PubMed  Google Scholar 

  14. Ishii Y, Noguchi H, Takeda M, Sato J, Toyabe S (2011) Prediction of range of motion 2 years after mobile-bearing total knee arthroplasty: PCL-retaining versus PCL-sacrificing. Knee Surg Sports Traumatol Arthrosc 19(12):2002–2008

    Article  PubMed  Google Scholar 

  15. Jones RE (2006) High-flexion rotating-platform knees: rationale, design, and patient selection. Orthopedics 29(9 Suppl):S76–S79

    PubMed  Google Scholar 

  16. Kotani A, Yonekura A, Bourne RB (2005) Factors influencing range of motion after contemporary total knee arthroplasty. J Arthroplasty 20(7):850–856

    Article  PubMed  Google Scholar 

  17. Matsuda S, Mizu-uchi H, Fukagawa S, Miura H, Okazaki K, Matsuda H, Iwamoto Y (2010) Mobile-bearing prosthesis did not improve mid-term clinical results of total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 18(10):1311–1316

    Article  PubMed  Google Scholar 

  18. Mont MA (2012) No difference in results of mobile-bearing versus fixed-bearing total knee arthroplasty in a prospective randomized study. J Bone Joint Surg Am 94(12):1–3

    Google Scholar 

  19. Parsley BS, Engh GA, Dwyer KA (1992) Preoperative flexion. Does it influence postoperative flexion after posterior-cruciate-retaining total knee arthroplasty? Clin Orthop Relat Res 275:204–210

    PubMed  Google Scholar 

  20. Post ZD, Matar WY, van de Leur T, Grossman EL, Austin MS (2010) Mobile-bearing total knee arthroplasty: better than a fixed-bearing? J Arthroplasty 25(6):998–1003

    Article  PubMed  Google Scholar 

  21. Ranawat AS, Gupta SK, Ranawat CS (2006) The P.F.C. sigma RP-F total knee arthroplasty: designed for improved performance. Orthopedics 29(9 Suppl):S28–S29

    PubMed  Google Scholar 

  22. Ranawat CS, Komistek RD, Rodriguez JA, Dennis DA, Anderle M (2004) In vivo kinematics for fixed and mobile-bearing posterior stabilized knee prostheses. Clin Orthop Relat Res 418:184–190

    Article  PubMed  Google Scholar 

  23. Ritter MA, Campbell ED (1987) Effect of range of motion on the success of a total knee arthroplasty. J Arthroplasty 2(2):95–97

    Article  CAS  PubMed  Google Scholar 

  24. Ritter MA, Stringer EA (1979) Predictive range of motion after total knee replacement. Clin Orthop Relat Res 143:115–119

    PubMed  Google Scholar 

  25. Ritter MA, Harty LD, Davis KE, Meding JB, Berend ME (2003) Predicting range of motion after total knee arthroplasty. Clustering, log-linear regression, and regression tree analysis. J Bone Joint Surg Am 85-A(7):1278–1285

    PubMed  Google Scholar 

  26. Sawaguchi N, Majima T, Ishigaki T, Mori N, Terashima T, Minami A (2010) Mobile-bearing total knee arthroplasty improves patellar tracking and patellofemoral contact stress: in vivo measurements in the same patients. J Arthroplasty 25(6):920–925

    Article  PubMed  Google Scholar 

  27. Schurman DJ, Matityahu A, Goodman SB, Maloney W, Woolson S, Shi H, Bloch DA (1998) Prediction of postoperative knee flexion in Insall-Burstein II total knee arthroplasty. Clin Orthop Relat Res 353:175–184

    Article  PubMed  Google Scholar 

  28. Smith H, Jan M, Mahomed NN, Davey JR, Gandhi R (2011) Meta-analysis and systematic review of clinical outcomes comparing mobile bearing and fixed bearing total knee arthroplasty. J Arthroplasty 26(8):1205–1213

    Article  PubMed  Google Scholar 

  29. Turki HW, Trick L (2011) Complete 180° rotatory dislocation in a mobile-bearing knee prosthesis. J Arthroplasty 26(4):666. e1–666. e3

    Article  Google Scholar 

  30. Winemaker M, Rahman WA, Petruccelli D, de Beer J (2012) Preoperative knee stiffness and total knee arthroplasty outcomes. J Arthroplasty 27(8):1437–1441

    Article  PubMed  Google Scholar 

  31. Woolson ST, Epstein NJ, Huddleston JI (2011) Long-term comparison of mobile-bearing vs filed-bearing total knee arthroplasty. J Arthroplasty 26(8):1219–1223

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, UT Southwestern Medical Center, 1801 Inwood Rd, Dallas, TX, 75235, USA

    Robert D. Russell, Michael H. Huo & Richard E. Jones

  2. 5920 Forest Park Rd #600, Dallas, TX, 75235, USA

    Leslie de Jong & Richard E. Jones

Authors
  1. Robert D. Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael H. Huo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Leslie de Jong
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Richard E. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert D. Russell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Russell, R.D., Huo, M.H., de Jong, L. et al. Preoperative flexion does not influence postoperative flexion after rotating-platform total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 22, 1644–1648 (2014). https://doi.org/10.1007/s00167-013-2378-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-013-2378-2

Keywords

Search

Navigation