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High-flexion total knee arthroplasty improves flexion of stiff knees

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

Abstract

Purpose

High-flexion knee prosthesis designs are generally thought to be of benefit only in patients with a satisfactory preoperative flexion angle. The aim of the study was to evaluate whether high-flexion designs were indeed worthless in osteoarthritis patients with severe preoperative flexion limitation.

Methods

The postoperative maximum flexion was compared in osteoarthritis patients with a preoperative maximum flexion of 100° or less, using LPS and LPS-flex implants (NexGen®; Zimmer, Warsaw, IN) in total knee arthroplasties. Data on 39 knees in the LPS group and 41 in the LPS-flex group, with a minimum of 2 years of follow-up, were reviewed retrospectively, focused on the postoperative maximum flexion.

Results

Two years after operation, the LPS-flex group had a mean postoperative maximum flexion of 131 ± 10° (range, 105–140°), which was significantly higher than the 121 ± 12° (range, 95–140°) in the LPS group (P < 0.001). In the LPS-flex group, about half of the knees (n = 18, 44%) could achieve a maximum flexion of 140° postoperatively, but in the LPS group only five knees (13%) achieved a maximum flexion of 140°.

Conclusion

Despite a different period of the operation between groups, this study suggested that osteoarthritis patients with severe preoperative flexion limitation could achieve more postoperative gain in flexion when a high-flexion prosthesis was used, compared to the flexion obtained using a standard prosthesis.

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Acknowledgments

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010-0001733).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, Ulsan University, 388-1, Pungnap-2-dong, Songpa-gu, Seoul, 138-736, South Korea

    Bum-Sik Lee, Jong-Min Kim, Sang-Jin Lee & Seong-Il Bin

  2. Department of Orthopaedic Surgery, Ulsan University Hospital, 290-3, Jeonha-dong, Dong-gu, Ulsan, 682-714, South Korea

    Kwang-Hwan Jung

  3. Department of Orthopaedic Surgery, Korea University Anam Hospital, College of Medicine, Korea University, Anam-dong 5-Ga, Seongbuk-gu, Seoul, 136-705, South Korea

    Dae-Hee Lee

  4. Department of Biomedical Engineering, College of Medicine, Chungbuk National University, Gaesin-dong, Heungdeok-gu, Cheongju, Chungcheongbuk-do, 361-763, South Korea

    Eun-Jong Cha

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  1. Bum-Sik Lee
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  2. Jong-Min Kim
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Correspondence to Seong-Il Bin.

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Lee, BS., Kim, JM., Lee, SJ. et al. High-flexion total knee arthroplasty improves flexion of stiff knees. Knee Surg Sports Traumatol Arthrosc 19, 936–942 (2011). https://doi.org/10.1007/s00167-010-1272-4

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  • DOI: https://doi.org/10.1007/s00167-010-1272-4

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