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Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty

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Abstract

Purpose

This study aimed to evaluate the safety and efficacy of fusiform capsulectomy of posterior capsule in correcting severe flexion contracture during total knee arthroplasty (TKA).

Methods

A retrospective analysis was performed in the patients who had preoperative severe flexion contracture (> 30 degrees) prior to TKA and received fusiform capsulectomy of posterior capsule during TKA between December 2013 and November 2018. Range of motion (ROM), knee functional score, forgotten joint score (FJS), post-operative complications, and radiographic results were collected and evaluated.

Result

Twenty patients (32 knees) were enrolled in this study. The mean duration of follow-up was 27.19 ± 15.92 months. The flexion contracture improved from pre-operative 37.69 ± 11.79° to post-operative 5.78 ± 4.44° (p < 0.001), and ROM increased from pre-operative 63.50 ± 21.74° to post-operative 97.88 ± 13.20° (p < 0.001). KSS clinical score increased from pre-operative 32.94 ± 11.03 to post-operative 82.34 ± 10.73 (p < 0.001), and KSS function score increased from pre-operative 28.97 ± 18.43 to post-operative 68.75 ± 15.96 (p < 0.001). The post-operative FJS was 76.08 ± 2.14. There was no implant loosening, infection, obvious haematoma formation, resultant instability, neurovascular complications, or revision for any reasons in the cohort until the last follow-up.

Conclusions

The technique of fusiform capsulectomy of posterior capsule to correct the severe flexion contracture during primary TKA is safe and effective and could provide good short-term results.

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Author information

Author notes

  1. Wei Chai and Qun-Qun Chen contributed equally to this work are considered co-first authors.

Authors and Affiliations

  1. Department of Orthopaedic Surgery, the first Medical Centre, Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, 100853, China

    Wei Chai, Zhuo Zhang, Ren-Wen Guo & Ji-Ying Chen

  2. Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China

    Qun-Qun Chen

  3. Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago medicine and Biological Sciences, Chicago, USA

    Lewis Shi

  4. Department of Orthopaedic and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong

    Chun-Hoi Yan

Authors
  1. Wei Chai
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  2. Qun-Qun Chen
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  3. Zhuo Zhang
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  4. Lewis Shi
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  5. Chun-Hoi Yan
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  6. Ren-Wen Guo
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  7. Ji-Ying Chen
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Correspondence to Wei Chai.

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The authors declare that they have no conflict of interest.

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Level of evidence: IV, therapeutic study

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Chai, W., Chen, QQ., Zhang, Z. et al. Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty. International Orthopaedics (SICOT) 45, 1463–1468 (2021). https://doi.org/10.1007/s00264-020-04792-7

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  • DOI: https://doi.org/10.1007/s00264-020-04792-7

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