TKA for stiffness may improve postoperative range of motion
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SAN DIEGO — Patients undergoing total knee arthroplasty for stiffness may experience improvement in postoperative range of motion, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
Ioannis Gkiatas, MD, PhD, and colleagues measured range of motion preoperatively and at 6 weeks and 6 months and 12 months postoperatively among patients who underwent revision TKA due to knee stiffness.
“We defined stiffness in our patients [as] when the knee flexion was less than 100° and the extension was more than 10°,” Gkiatas, who was a research fellow at the Stavros Niarchos Foundation Complex Joint Reconstruction Center at Hospital for Special Surgery at the time the study was conducted, told Healio Orthopedics.
Researchers established progression thresholds using a preoperative range of motion of greater than 64° and a 6-week postoperative range of motion greater than 82°. Gkiatas noted patients were identified as having severe knee stiffness if they had a range of motion less than 64° preoperatively and range of motion that did not reach 82° at 6 weeks postoperatively. Researchers plotted and stratified range of motion by progression and severity level, and categorized range of motion as gained, maintained or loss.
Gkiatas noted 80% of patients who were able to reach 82° of range of motion at 6 weeks postoperatively either gained or maintained that range of motion by 6 months postoperatively.
“So, 80% of the patients who reached 82° or greater at 6 weeks, they would at least maintain or gain more range of motion at 6 months, and 60% of these patients at least maintained their range of motion at 1 year,” Gkiatas, who is currently an academic associate in the orthopedic department at the University of Ioannina in Greece, said.
Patients with preoperative range of motion less than 64° experienced a regression in range of motion by 6 months postoperatively, according to Gkiatas. He added this regression in range of motion continued at 1-year postoperatively.
“This is helpful, in our minds, for the clinician and the patient because if the patient goes to the clinic with a stiff total knee arthroplasty and he needs a revision, then, according to the preoperative range of motion, the physician can guide the patient what to expect,” Gkiatas said.
Gkiatas added this study was conducted under the supervision of Peter K. Sculco, MD, attending hip and knee surgeon at Hospital for Special Surgery, who is leading a large ongoing study regarding stiffness in TKA.
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Gkiatas I, et al. Poster 0628. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. Aug. 31 - Sept. 3, 2021; San Diego.
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