2021 ISAKOS Biennial Congress ePoster
Knee flexion contracture does not impact knee function after TKA: a case control study about 4154 cases.
Andrea Fernandez, MD, Nancy, Lorraine FRANCE
Elliot Sappey-Marinier, MD, Lyon, Rhône FRANCE
Cécile Batailler, MD, PhD, Lyon, Rhône Alpes FRANCE
Elvire Servien, MD, PhD, Prof., Lyon, Rhône Alpes FRANCE
Sebastien Lustig, MD, PhD, Lyon, Rhône Alpes FRANCE
Croix-Rousse Hospital, Lyon University Hospital, Lyon, Rhône Alpes, FRANCE
FDA Status Not Applicable
Summary
Effects of preoperative knee contracture on functional outcomes
ePosters will be available shortly before Congress
Abstract
Introduction
One of the primary issues conducting a primary total knee arthroplasty is the management of a native preoperative flessum, usually associated with poor post-operative knee function. Our study aimed to assess the functional results of a primary TKA using a standardized algorithm to manage pre-operative flessum.
Methods
A retrospective single center case-control study was conducted from January 2000 to December 2016 at the Orthopedic Surgery Department of the Lyon University Hospital. Were included all consecutive patients with a pre-operative flessum superior to 10° and were randomly selected controls with a 1-4 cases ratio. Knees were assessed pre- and post-operatively using the Knee Society Score (KSS).
Level of significance was set at p<0.05.
Results
849 cases and 3305 controls were included, 2839 men and 1315 women. The mean pre-operative extension deficit was 13.22° [10-55] for the flessum group and 0° [-5:9] for the control group. Pre-operative KSS knee score and KSS function score were significantly inferior in the flessum group (41.5 ± 18.2 and 55.3 ± 20) than in the control group (53.8 ± 15.8 and 59.3 ± 19.5) (P< 0.0001). After TKA, analysis between flessum group and control group found respectively no significant difference for the KSS function score (76.9 ± 23.1 vs 78.5 ± 21.8, P=0.168), but a statistical difference in the KSS knee score (87.2 ± 12.3 vs 88.1 ± 12.9, P=0.003). Moreover, a significant difference was found regarding post-operative KSS pain subscore (45.1± 8.2 vs 43.9 ± 9.6, P=0.015), post-operative knee extension deficit (1.2 ± 3.1 vs -0.3 ± 1.7, P<0.0001), post-operative maximum knee flexion (114.4 ± 13.9 vs 118.9 ± 13.5, P<0.0001).
Conclusion
A standardized and systematic algorithm to manage pre-operative knee flessum in TKA procedures showed statistically different but clinically similar outcomes than TKA for patients without pre-operative knee flexion contracture.