Revision for stiffness following TKA: a predictable procedure?
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Published on: February 27, 2018
Gregory K Kim1, S M Javad Mortazavi, Javad Parvizi
1Rothman Institute of Orthopedics at Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
Background:
Stiffness is a known complication following total knee arthroplasty. Multiple options are available to address this problem but revision TKA has been reported to be an effective treatment especially in the presence of technical issues such as oversized or loose components. However, it is not clearly known what factors may affect the outcome of revision TKA for stiffness. The purpose of this study was to evaluate the results of TKA revision for stiffness and to determine which potential factors may predict the outcome.
Materials And Methods:
Between 1999 and 2006, 39 patients (24 females and 15 males) were revised for stiffness following their primary TKA. The average age was 60.8 years with an average BMI of 30.7. The mean follow up was 74.4 months.
Results:
Following revision TKA, the overall range of motion and flexion contracture improved significantly from 68 to 90 (p=0.001) and from 14 to 5 (p<0.0001), respectively. Although the KSS were significantly improved from 45.72 to 77.10 (p<0.0001), the functional score did not improve significantly. Of the 39 knees which had stiffness, 10 (25.6%) required a second revision. We could not find any demographic or operative characteristics as a predictor failure.
Conclusion:
Our study shows that TKA revision is a viable option, still unpredictable, to improve the ROM in patients with prolonged stiffness after TKA. Although revision for stiffness is not always successful in terms of achieving functional range of motion, it could improve pain in presence of less than functional range of motion.
Level Of Evidence:
Prognostic Level II.