Preoperative flexion contracture does not affect outcome in total knee arthroplasty: A case-control study of 2,634 TKAs.
Knee arthroplasty
Knee osteoarthritis
Surgical procedure
Journal
Orthopaedics & traumatology, surgery & research : OTSR
ISSN: 1877-0568
Titre abrégé: Orthop Traumatol Surg Res
Pays: France
ID NLM: 101494830
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
09
05
2022
revised:
04
01
2023
accepted:
18
01
2023
medline:
22
8
2023
pubmed:
17
3
2023
entrez:
16
3
2023
Statut:
ppublish
Résumé
One issue in total knee arthroplasty (TKA) is management of preoperative flexion contracture, which may be associated with poor functional outcome. The aim of this study was to compare functional results in TKA with or without preoperative flexion contracture, treated according to a standardized algorithm of tissue release and bone cut. A single-center retrospective case-control study was performed on prospectively collected data for the period 1987-2016. Patients with >10̊ flexion contracture were assigned to the "contracture" group and associated to a selected control group at a ratio of 1:4. Clinical analysis used pre and post-operative International Knee Society (IKS) scores. The significance threshold was set at p<0.05. Eight hundred and forty-nine cases and 3,304 controls were included, comprising a total of 2,838 male and 1,315 female participants. Mean preoperative extension deficit was 13̊±6̊ in the contracture group and 1̊±2̊ in controls. Preoperative IKS total and functional scores were significantly poorer in the contracture group (38±18 and 54±20) than in controls (52±16 and 59±19) (p<0.001). Postoperatively, the two groups did not significantly differ in IKS functional score (77±22 vs. 79±21, p=0.143). There were differences in IKS knee score (87±12 vs. 88±13, p=0.006) and maximal flexion (114̊±14̊ vs. 119̊±13̊, p<0.0001) that were statistically, but not clinically, significant. A systematic standardized algorithm for surgical treatment of flexion contracture during primary total knee arthroplasty provided clinical outcomes similar to those of patients without preoperative flexion contracture. III; case-control study.
Sections du résumé
BACKGROUND
One issue in total knee arthroplasty (TKA) is management of preoperative flexion contracture, which may be associated with poor functional outcome.
AIM
The aim of this study was to compare functional results in TKA with or without preoperative flexion contracture, treated according to a standardized algorithm of tissue release and bone cut.
PATIENTS AND METHOD
A single-center retrospective case-control study was performed on prospectively collected data for the period 1987-2016. Patients with >10̊ flexion contracture were assigned to the "contracture" group and associated to a selected control group at a ratio of 1:4. Clinical analysis used pre and post-operative International Knee Society (IKS) scores. The significance threshold was set at p<0.05.
RESULTS
Eight hundred and forty-nine cases and 3,304 controls were included, comprising a total of 2,838 male and 1,315 female participants. Mean preoperative extension deficit was 13̊±6̊ in the contracture group and 1̊±2̊ in controls. Preoperative IKS total and functional scores were significantly poorer in the contracture group (38±18 and 54±20) than in controls (52±16 and 59±19) (p<0.001). Postoperatively, the two groups did not significantly differ in IKS functional score (77±22 vs. 79±21, p=0.143). There were differences in IKS knee score (87±12 vs. 88±13, p=0.006) and maximal flexion (114̊±14̊ vs. 119̊±13̊, p<0.0001) that were statistically, but not clinically, significant.
DISCUSSION
A systematic standardized algorithm for surgical treatment of flexion contracture during primary total knee arthroplasty provided clinical outcomes similar to those of patients without preoperative flexion contracture.
LEVEL OF EVIDENCE
III; case-control study.
Identifiants
pubmed: 36924881
pii: S1877-0568(23)00057-9
doi: 10.1016/j.otsr.2023.103592
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103592Informations de copyright
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