Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review.
Distal femoral cuts
Fixed flexion contracture
Posterior capsule release
Postoperative rehabilitation
Total knee arthroplasty
Journal
SICOT-J
ISSN: 2426-8887
Titre abrégé: SICOT J
Pays: France
ID NLM: 101675099
Informations de publication
Date de publication:
2024
2024
Historique:
received:
08
01
2024
accepted:
12
02
2024
medline:
26
3
2024
pubmed:
26
3
2024
entrez:
26
3
2024
Statut:
ppublish
Résumé
This study aimed to systematically review the literature and identify the surgical management strategy for fixed flexion contracture in primary total knee arthroplasty (TKA) surgery, pre-, intra-, and post-operatively. Secondary endpoints were etiologies and factors favoring flexion contracture. Searches were carried out in November 2023 in several databases (Pubmed, Scopus, Cochrane, and Google Scholar) using the following keywords: "flexion contracture AND TKA", "fixed flexion deformity AND TKA", "posterior capsular release AND TKA", "posterior capsulotomy in TKA", "distal femoral resection AND TKA". Study quality was assessed using the STROBE checklist and the Downs and Black score. Data concerning factors or strategies leading to the development or prevention of flexion contracture after TKA were extracted from the text, figures, and tables of the included references. The effect of each predictive factor on flexion contracture after TKA was recorded. Thirty-one studies were identified to meet the inclusion and exclusion criteria. These studies described a variety of preoperative and intraoperative factors that contribute to the development or correction of postoperative flexion contracture. The only clearly identified predictor of postoperative flexion contracture was preoperative flexion contracture. Intraoperative steps described to correct flexion contracture were: soft-tissue balancing (in posterior and medial compartments), distal femoral resection, flexion of the femoral component, and posterior condylar resection. However, no study has investigated these factors in a global model. This review identified various pre-, intra-, and post-operative factors predictive of post-operative flexion contracture. In practice, these factors are likely to interact, and it is therefore crucial to further investigate them in a comprehensive model to develop an algorithm for the management of flexion contracture. IV.
Identifiants
pubmed: 38530205
doi: 10.1051/sicotj/2024007
pii: sicotj240002
doi:
Types de publication
Journal Article
Langues
eng
Pagination
11Informations de copyright
© The Authors, published by EDP Sciences, 2024.
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