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Related Concept Videos

Knee Joint01:23

Knee Joint

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The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
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Functional Classification of Joints01:09

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Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses  or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
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Classification-Based Management of Stiff/Ankylosed Knees.

Mrinal Sharma1, Saurabh Sharma1, Akshay Raj Upadhyaya1

  • 1Asian Institute of Medical Sciences, Badkal Flyover Road, Sec 21A, Faridabad, Delhi NCR India.

Indian Journal of Orthopaedics
|November 26, 2021
PubMed
Summary

This study introduces a new classification system for stiff or ankylosed knees, improving surgical management and patient outcomes. The classification helps surgeons choose appropriate approaches and implants for better results in complex knee replacement cases.

Keywords:
Arc of motionBony ankylosisClassificationHinged implantsStiff kneesTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Stiff knees, defined by limited range of motion (<50°), present significant surgical challenges.
  • Developing effective management strategies for stiff and ankylosed knees is crucial for improving patient function.
  • Previous approaches lacked a standardized classification, complicating surgical decision-making.

Purpose of the Study:

  • To present a novel working classification for managing stiff and ankylosed knees.
  • To outline a flowchart-based approach for surgical intervention in these complex cases.
  • To evaluate the efficacy and outcomes of the proposed classification system.

Main Methods:

  • A retrospective study of 61 patients undergoing total knee arthroplasty (TKA) for stiff or ankylosed knees over five years.
  • Classification based on the type of ankylosis (fibrous or bony) and preoperative range of motion (ROM).
  • Analysis of patient outcomes including knee society score (KSS) pain and function, ROM, and complications.

Main Results:

  • Significant improvements in KSS pain (32 to 76) and function (36 to 78) were observed postoperatively.
  • Average ROM improved from 35.6° preoperatively to 95.6° postoperatively.
  • Stiff knees (types 1 and 2) showed better outcomes than ankylosed knees (type 3), with a 24% complication rate.

Conclusions:

  • The developed classification system provides a valuable tool for surgeons managing stiff and ankylosed knees.
  • It aids in selecting appropriate surgical approaches and implants, offering predictive and prognostic insights.
  • This classification enhances decision-making, potentially leading to improved functional outcomes in complex TKA cases.