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Updated: Nov 16, 2025
In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
Wound closure position in total knee arthroplasty: flexion versus extension-a meta-analysis of randomized controlled
Xiaomin Lu1, Lilun Zhong2, Xuewei Cao3
1Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People's Republic of China.
Background:
Total knee arthroplasty (TKA) is one of the most commonly used procedures in orthopedics. However, whether different would closure positions affect the clinical outcomes after TKA remains controversial. We conducted a meta-analysis of randomized controlled trials (RCT) to assess the effect of wound closure position on clinical TKA outcomes.
Methods:
Embase, PubMed, and the Cochrane Library databases were systematically searched. A systematic review and meta-analysis of all RCTs were performed to prove the role of different wound closure positions on TKA.
Results:
Five RCTs containing 389 patients were included. Surgical closure of 90° flexion in TKA was associated with higher post-operative range-of-motion (ROM) at post-operative 4 weeks, lower VAS post-operative pain scores 4 weeks and 3 months, better peak torque difference of flexor muscle strength at 60 and 180°/s angular velocities between the flexion and the extension groups, and better total work difference of flexor muscle strength at 180°/s angular velocity. The American Knee Society Score did not show any significant difference between two closure techniques. No complications were described in the literature review.
Conclusions:
Wound closure in 90° flexion during TKA may provide better postoperative ROM, higher pain relief, preferable muscle strength improvement in short-term follow-up, and no increase in the risks of wound complications.
Level Of Evidence:
Level II.
