The Journal of Bone and Joint Surgery (American). 2008;90:777-784.
doi:10.2106/JBJS.F.01022
© 2008 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the exam for this article:
 CME 2: April, May, June 2008 (publication date July 3, 2008; expiration dat...
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Google Scholar
Right arrow Articles by Ritter, M. A.
Right arrow Articles by Berend, M. E.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ritter, M. A.
Right arrow Articles by Berend, M. E.
Related Collections
Right arrow Adult Knee
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

The Effect of Postoperative Range of Motion on Functional Activities After Posterior Cruciate-Retaining Total Knee Arthroplasty

Merrill A. Ritter, MD1, Joseph D. Lutgring, BS1, Kenneth E. Davis, MS1 and Michael E. Berend, MD1

1 The Center for Hip and Knee Surgery, St. Francis Hospital, 1199 Hadley Road, Mooresville, IN 46158. E-mail address for M.A. Ritter: marittermd{at}yahoo.com
Investigation performed at the Center for Hip and Knee Surgery, St. Francis Hospital, Mooresville, Indiana

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Biomet. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: Range of motion is recognized as an important indicator of the success of a total knee replacement; however, an optimal range of motion has yet to be defined. This study was designed to determine the optimal range of motion for knee function after total knee arthroplasty with a posterior cruciate-retaining prosthesis.

Methods: We retrospectively reviewed 5556 primary total knee arthroplasties performed with posterior cruciate-retaining prostheses between 1983 and 2003. The relationship between postoperative range of motion and pain, walking ability, stair-climbing ability, and knee function scores was examined at three to five years postoperatively. The relationship between a postoperative flexion contracture or hyperextension and knee function was also examined.

Results: Patients with 128° to 132° of motion obtained the highest scores for pain, walking, and knee function and the highest Knee Society scores. The outcomes became substantially compromised with motion of <118°. Patients with 133° to 150° of motion had the highest scores for stair-climbing. A postoperative flexion contracture and hyperextension were associated with lower scores for pain, walking, stair-climbing, and knee function.

Conclusions: The best functional results following total knee arthroplasty are achieved with 128° to 132° of motion. A postoperative flexion contracture and hyperextension of ≥10° are associated with a poorer outcome except that stair-climbing is improved with more motion.

Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?