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Background: This study aimed to analyze the risk factors that predict recurrent flexion contracture (FC) after total knee arthroplasty (TKA) in osteoarthritic knees with FC ≥ 15°.

Methods: Data from a consecutive cohort comprising 237 TKAs in 187 patients with degenerative osteoarthritis, preoperative FC ≥ 15°, and a minimum follow-up period of 2 years were retrospectively reviewed. Preoperative FC was corrected intraoperatively from 0° to 5°. The incidence of recurrent FC (FC ≥ 10°) at 2 years postoperatively was investigated. Potential risk factors predicting recurrent FC including age, sex, body mass index, unilateral TKA, severity of preoperative FC, 3-month postoperative residual FC, γ angle, change in posterior femoral offset ratio, and lumbar degenerative kyphosis (LDK) were analyzed using logistic regression analysis. The post-hoc powers for the identified factors were then determined.

Results: Forty-one knees (17.3%) with recurrent FC were identified. Risk factors with sufficient power for recurrent FC were unilateral TKA, severity of preoperative FC, residual FC at 3 months postoperatively, and LDK (odds ratios of 3.579, 1.115, 1.274, and 3.096, respectively; p < 0.05; power ≥ 86.1).

Conclusions: Recurrent FC can occur in TKAs with the risk factors including unilateral TKA, severe preoperative FC, residual FC at 3 months postoperative, and LDK despite appropriate intraoperative correction. Surgical strategies and rehabilitation protocols used in managing FC should be applied in TKA cases with risk factors for recurrent FC.

Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Titel:	Predictors of Recurrent Flexion Contracture after Total Knee Arthroplasty in Osteoarthritic Knees with Greater Than 15° Flexion Contracture.
Autor/in / Beteiligte Person:	Song, SJ ; Lee, HW ; Park, CH
Link:	Full Text Finder (Volltext)
Zeitschrift:	Clinics in orthopedic surgery, Jg. 15 (2023-10-01), Heft 5, S. 770-780
Veröffentlichung:	Seoul : Korean Orthopaedic Association, 2023
Medientyp:	academicJournal
ISSN:	2005-4408 (electronic)
DOI:	10.4055/cios22207
Schlagwort:	Humans Knee Joint surgery Retrospective Studies Treatment Outcome Range of Motion, Articular Arthroplasty, Replacement, Knee adverse effects Arthroplasty, Replacement, Knee methods Contracture etiology Contracture surgery Osteoarthritis, Knee surgery Osteoarthritis, Knee complications
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Clin Orthop Surg] 2023 Oct; Vol. 15 (5), pp. 770-780. <i>Date of Electronic Publication: </i>2022 Nov 22. MeSH Terms: Arthroplasty, Replacement, Knee* / adverse effects ; Arthroplasty, Replacement, Knee* / methods ; Contracture* / etiology ; Contracture* / surgery ; Osteoarthritis, Knee* / surgery ; Osteoarthritis, Knee* / complications ; Humans ; Knee Joint / surgery ; Retrospective Studies ; Treatment Outcome ; Range of Motion, Articular References: J Surg Orthop Adv. 2008 Winter;17(4):231-8. (PMID: 19138496) ; J Arthroplasty. 2016 Jan;31(1):128-31. (PMID: 26404849) ; J Orthop Sci. 2019 Jul;24(4):674-679. (PMID: 30638970) ; J Bone Joint Surg Am. 2005;87 Suppl 2:9-21. (PMID: 16326719) ; J Arthroplasty. 2012 Jun;27(6):1155-8. (PMID: 22342129) ; Knee Surg Sports Traumatol Arthrosc. 2010 Feb;18(2):194-9. (PMID: 19826784) ; Orthopedics. 2011 Dec 06;34(12):e855-9. (PMID: 22146201) ; J Arthroplasty. 2011 Jun;26(4):639-43. (PMID: 20541887) ; Knee. 2008 Dec;15(6):467-72. (PMID: 18760608) ; J Arthroplasty. 2019 Jul;34(7):1476-1482. (PMID: 30905642) ; J Arthroplasty. 2020 Jun;35(6S):S330-S335. (PMID: 32169383) ; Haemophilia. 2012 May;18(3):358-63. (PMID: 22103453) ; J Knee Surg. 2022 Nov;35(13):1409-1416. (PMID: 33618399) ; J Arthroplasty. 2007 Dec;22(8):1092-6. (PMID: 18078875) ; Clin Orthop Relat Res. 1992 Nov;(284):221-7. (PMID: 1395297) ; Knee Surg Relat Res. 2021 Dec 4;33(1):43. (PMID: 34863317) ; Knee. 2019 Aug;26(4):905-913. (PMID: 31229289) ; Spine (Phila Pa 1976). 2012 May 20;37(12):1077-82. (PMID: 22045006) ; J Arthroplasty. 2020 Nov;35(11):3172-3179. (PMID: 32665154) ; Knee Surg Relat Res. 2021 Nov 10;33(1):41. (PMID: 34758870) ; Knee. 2018 Jun;25(3):352-359. (PMID: 29681527) ; Eur Spine J. 2011 Sep;20 Suppl 5:681-5. (PMID: 21870096) ; J Bone Joint Surg Br. 2012 Nov;94(11 Suppl A):112-5. (PMID: 23118396) ; BMC Musculoskelet Disord. 2022 Apr 8;23(1):339. (PMID: 35395849) ; BMC Musculoskelet Disord. 2022 Jan 22;23(1):78. (PMID: 35065647) ; J Arthroplasty. 2017 Mar;32(3):783-787.e1. (PMID: 27720514) ; J Korean Neurosurg Soc. 2017 Mar;60(2):125-129. (PMID: 28264231) ; Clin Orthop Relat Res. 2009 Jun;467(6):1485-92. (PMID: 19333671) ; Neurosurg Clin N Am. 2018 Jul;29(3):323-329. (PMID: 29933800) ; Knee. 2012 Oct;19(5):519-21. (PMID: 21996572) ; Clin Orthop Relat Res. 2006 Nov;452:83-7. (PMID: 16957650) ; Arch Orthop Trauma Surg. 2021 Oct;141(10):1779-1788. (PMID: 33599846) ; Int Orthop. 2012 Sep;36(9):1835-9. (PMID: 22638608) ; Int Orthop. 2013 Oct;37(10):1917-23. (PMID: 23835560) ; PM R. 2015 May;7(5):466-73. (PMID: 25511691) ; Knee Surg Relat Res. 2022 Jun 18;34(1):29. (PMID: 35717341) ; Knee. 2012 Dec;19(6):843-5. (PMID: 22682692) ; J Bone Joint Surg Am. 2008 Apr;90(4):777-84. (PMID: 18381316) ; Orthop Traumatol Surg Res. 2009 Jun;95(4 Suppl 1):S7-12. (PMID: 19442598) ; J Arthroplasty. 2015 Dec;30(12):2154-8. (PMID: 26160647) ; J Arthroplasty. 2017 Sep;32(9):2717-2724. (PMID: 28487091) ; Knee Surg Relat Res. 2022 Apr 8;34(1):20. (PMID: 35395934) Contributed Indexing: Keywords: Arthroplasty; Flexion contracture; Knee; Risk factor Entry Date(s): Date Created: 20231009 Date Completed: 20231101 Latest Revision: 20231101 Update Code: 20231215 PubMed Central ID: PMC10551682

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Predictors of Recurrent Flexion Contracture after Total Knee Arthroplasty in Osteoarthritic Knees with Greater Than 15° Flexion Contracture.