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The effect of gastrocnemius resection on knee flexion in a total knee arthroplasty model

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Flexion contracture in knee arthritis and total knee arthroplasty (TKA) is a common and significant problem. An improvement in knee extension in patients with TKA and mild flexion contractures has been observed clinically when a gastrocnemius recession was performed for other concomitant conditions. The goal of this study was to quantify the effect of gastrocnemius recession on knee flexion in TKA cadaver model.

Materials and methods

Range of motion (ROM) of 23 cadaveric knees was determined with a navigation system before and after performing TKA using a medial parapetallar approach and after performing a gastrocnemius recession. Varus-valgus, flexion–extension, and internal–external rotation angles of the knee joint were recorded with leg in full extension and in 90°of knee flexion. Extension and flexion gaps were measured using a gap tensioning device. Dorsiflexion of the foot was measured with a goniometer when a torque moment of 10 Nm was applied to the ankle joint.

Results

A statistically significant improvement of 5° in knee extension was observed following gastrocnemius recession (P = 0.015). Varus and valgus angles, internal, and external rotation were unaffected by gastrocnemius recession. Ankle dorsiflexion increased by 9° following gastrocnemius recession (P ≤ 0.001).

Conclusions

Performing a gastrocnemius recession improves the knee extension in TKA knees with flexion contractures. Gastrocnemius recession may be a useful technique to improve terminal extension in TKA.

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Acknowledgements

Cadavers and equipment were sponsored by DJO Global (DJO, LLC, Vista, CA-US).

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Authors and Affiliations

  1. Utah Orthopaedics, 5782 Adams Avenue Parkway, Ogden, UT, 84405, USA

    Jeffrey Rocco & Alexandra Rocco

  2. Department of Orthopaedics—Experimental Orthopaedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria

    David Putzer & Michael Nogler

  3. Department of Orthopaedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria

    Martin Thaler

  4. Joint Reconstructive Specialists, Inc., 3110 SW 89th Street Suite 200D, Oklahoma City, OK, 73159, USA

    Paul Maitino

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  1. Jeffrey Rocco
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  2. David Putzer
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  4. Alexandra Rocco
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Correspondence to Jeffrey Rocco.

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Conflict of interest

Jeffrey Rocco and Paul Maitino are paid consultants of DJO Global. Michael Nogler received research support and royalties from DJO Global. Martin Thaler, Paul Maitino and Michael Nogler are paid speakers for DJO Global. Michal Nogler is a paid speaker for Stryker. There are no other conflicts of interest to declare.

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Rocco, J., Putzer, D., Nogler, M. et al. The effect of gastrocnemius resection on knee flexion in a total knee arthroplasty model. Arch Orthop Trauma Surg 142, 2503–2511 (2022). https://doi.org/10.1007/s00402-020-03695-x

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  • DOI: https://doi.org/10.1007/s00402-020-03695-x

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