Factors affecting postoperative flexion in total knee arthroplasty

In the review of 67 cases with total condylar (TC) prostheses, 59 with TC posterior stabilizers, 70 with TC prostheses modified with flat posterior tibial plateau, and 35 with porous-coated arthroplasty (PCA) prostheses, multiple cross-examinations of various factors for postoperative flexion were performed. Follow up was 2 to 9 years. In nearly all cases, no further improvement of flexion was noted after 1 year following surgery. The most influential factor for good postoperative flexion was intense physical therapy, leading to good suprapatellar pouch reconstitution. Residual flexion contracture was more frequent when the posterior cruciate ligament (PCL) was retained in the cases with significant preoperative flexion contracture. However, retention of PCL or preoperative ACL condition did not bear any significance to the ultimate flexion.