Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty
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ORIGINAL PAPER
Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty Wei Chai 1
&
Qun-Qun Chen 2 & Zhuo Zhang 1 & Lewis Shi 3 & Chun-Hoi Yan 4 & Ren-Wen Guo 1 & Ji-Ying Chen 1
Received: 4 May 2020 / Accepted: 1 September 2020 # SICOT aisbl 2020
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 postoperative 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. Keywords Knee replacement . Severe flexion contracture . Capsulectomy
Introduction Wei Chai and Qun-Qun Chen contributed equally to this work are considered co-first authors. Level of evidence: IV, therapeutic study * Wei Chai [email protected] 1
Department of Orthopaedic Surgery, the first Medical Centre, Chinese PLA General Hospital, No.28 Fuxing Road, Beijing 100853, China
2
Department of Orthopaedic Surgery, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
3
Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Chicago medicine and Biological Sciences, Chicago, USA
4
Department of Orthopaedic and Traumatology, Queen Mary Hospital, Hong Kong, Hong Kong
Total knee arthroplasty (TKA) is the definitive treatment option for end-stage knee disease. It could provide excellent clinical outcomes, particularly with pain relief and functional restoration. Flexion contracture is one kind of the most complex of primary knee replacement. Residual flexion contracture requires the quadriceps to exert extra force in walking, which could easily lead to poor joint function and component aseptic loose
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