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Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty

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

Abstract

Purpose

The primary aim of this study was to evaluate the influence of postoperative fixed flexion deformity (FFD) on the clinical outcomes 10 years after unicompartmental knee arthroplasty (UKA). The secondary aim was to identify predictors for the occurrence of postoperative FFD.

Methods

Patients who underwent UKA between 2003 and 2007 were prospectively followed up for 10 years. A total of 172 patients were categorized into 3 groups based on the amount of postoperative FFD: (1) 0° or less (Min-FFD), (2) 1°–9° (Mid-FFD), and (3) 10° or more (Max-FFD). Functional outcome was quantified using Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS) and Oxford Knee Score (OKS).

Results

At 10 years after UKA, the mean KSKS and OKS were 6 ± 5 (95% CI 6–18, p = 0.050) and 5 ± 2 (95% CI 0–9, p = 0.041) points lower in patients with Max-FFD than those with Min-FFD. Other clinical outcomes were not different between groups. Patients with a higher preoperative body mass index (OR 1.122 per unit increase, 95% CI 1.006–1.253, p = 0.040) or worse preoperative FFD (OR 1.108 per unit increase, 95% CI 1.022–1.201, p = 0.013) were at increased risk of having postoperative FFD of 10° or more at 10 years after UKA.

Conclusions

The clinical relevance of this study was to demonstrate the long-term negative correlation between severe postoperative FFD and functional outcome and, therefore, the importance of achieving good knee alignment after UKA. The authors recommend that FFD should be fully corrected intra-operatively if possible while preserving knee balance and stable dynamic function through full range of motion.

Level of evidence

Prognostic level II.

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Author information

Authors and Affiliations

  1. Duke-NUS Medical School, Singapore, Singapore

    Jared Ze Yang Yeh

  2. Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore

    Jerry Yongqiang Chen, Joel Wei-An Lim, Hee Nee Pang, Darren Keng Jin Tay, Shi-Lu Chia, Ngai Nung Lo & Seng Jin Yeo

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  1. Jared Ze Yang Yeh
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  2. Jerry Yongqiang Chen
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Correspondence to Jared Ze Yang Yeh.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Yeh, J.Z.Y., Chen, J.Y., Lim, J.WA. et al. Postoperative fixed flexion deformity greater than 10° lead to poorer functional outcome 10 years after unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 26, 1723–1727 (2018). https://doi.org/10.1007/s00167-017-4749-6

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  • DOI: https://doi.org/10.1007/s00167-017-4749-6

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