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Fixed flexion deformity reportedly a better result than genu recurvatum following TKR
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If neutral extension cannot be obtained after total knee replacement, researchers from Singapore recently concluded it may be better to end up with fixed flexion deformity than genu recurvatum.
Kevin Thien, MD, presented these findings at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting, in San Francisco.
“The goal of a total knee replacement is to achieve a good range of motion, and one means of achieving this goal is by bringing the knee into full extension — ie, 0°,” Thien said. “However, post-total knee replacement (TKR) the knee can either end up in a fixed flexion deformity (FFD) or in genu recurvatum (GR). To date, there are no studies comparing outcomes of FFD versus genu recurvatum post-[TKR].”
Thien and his team retrospectively reviewed all prospectively collected primary TKR data from cases performed at a single center between 2004 and 2008 (4,540 primary TKRs), according to their abstract. This review reportedly included patient biodata and post-TKR range of motion and clinical scores taken at the 6-month and 2-year follow-ups. Investigators then compared the scores of patients who displayed post-TKR GR with those who displayed post-TKR FFD.
At the 6-month mark, 254 knees were in GR while 2,162 knees had FFD. At the 2-year mark, 889 knees were in GR and 1,629 knees had FFD, Thien reported. According to the abstract, functional and pain scores were “significantly better” in the FFD group when compared to the GR group.
Further, it was reported in the abstract that for those patients — a majority — with extension of -10° to +10°, the Knee Society-Clinical and Oxford scores were significantly better for FFD vs. GR at the 6-month and 2-year follow-ups.
“To our knowledge ours is the only study directly comparing post-TKR fixed flexion and genu recurvatum deformities,” Thien said at the meeting. “We conclude it is better to err on the side of FFD if neutral extension cannot be achieved.”
Reference:
- Thien K, Silva A, Chong HC, et al. Genu recurvatum versus fixed flexion deformity after total knee arthroplasty – which is the lesser evil? Paper #9. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.
- Disclosure: Thien has no relevant financial disclosures.
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