Determinants of range of motion in cruciate retaining total knee arthroplasty: a prospective study

Abstract

<p class="abstract"><strong>Background:</strong> Total knee replacement (TKR) is to provide a stable painless knee with adequate range of motion (ROM) for daily activities. The aim of the study is to evaluate various factors that influence ROM in cruciate retaining TKR postoperatively.</p><p class="abstract"><strong>Methods:</strong> Fourty four patients with osteoarthritis knee treated in our institute with TKR using cruciate retaining prosthesis are included in study and analysed prospectively. Mean follow up was 6 months. Patients are analyzed for following factors–age, gender, BMI, preoperative ROM, changes in posterior femoral condylar offset, posterior tibial slope after surgery. Statistical analysis of effect of all factors on knee ROM was done. Assessment was done preoperatively and 3 and 6 months postoperatively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Gender did not affect the final ROM. Mean age of patients is 65. Age has negative correlation with ROM (p=-0.45). The mean knee range improved from 92˚ to 101˚. Factors that negatively affect ROM include, BMI (p=-0.04) and Preoperative flexion deformity (p=-0.03). Factors that positively affect ROM include, knee scores and good preoperative flexion (p=0.001). Males have good amount of flexion preoperatively and post operatively when compared to females.</p><p class="abstract"><strong>Conclusions:</strong> Preoperative ROM, flexion contracture and BMI are the important factors affecting the range of motion in total knee arthroplasty. Proper counselling of patient preoperatively regarding these various factors and appropriate selection of patient is of utmost important for satisfactory functional outcome.</p>