Total Knee Arthroplasty for Treatment of Osteoarthritis of The Knee with Fixed Flexion Deformity

Abstract

Background: Fixed flexion deformity (FFD) caused by osteoarthritis is primarily caused by the rigidity and tethering of posterior soft  tissues, particularly the posterior capsule. This results in functional, biomechanical, and gait limitations, affecting patients' ability to  perform daily activities and satisfaction after total knee replacement (TKR). Correcting FFD is crucial during TKR to improve postoperative  outcomes. Knee surgeons use various surgical corrective measures, but there is no universally accepted approach.

Objective: This study  aimed to assess and achieve an effective repair as a sequential stepwise strategy focusing on soft tissue incisions is recommended over  bone cuts.

Methods: The study involved 21 patients with 23 knees, treated at Benha University Hospitals.

Results: The postoperative  knee clinical score ranged from 66-93, with a mean of 78.87, and the mean functional knee score was 78.70. The total knee score,  including both clinical and functional scores, was 157.22, ranging from 121-173.

Conclusion: The stepwise approach for addressing fixed  flexion contracture in osteoarthritic knees during total knee replacement has shown significant efficacy in correcting deformity,  enhancing postoperative patient satisfaction, and achieving superior clinical outcomes