Restoration of Knee Motion After Total Knee Arthroplasty: Subvastus Approach and Alternate Flexion and Extension Splintage

Abstract

The aim of this study was to examine the factors controlling the ultimate range of motion (ROM) which can lead to a successful outcome of total knee arthroplasty (TKA). Among these factors, the efficiency of the postoperative continuous passive motion (CPM) and the alternate flexion and extension splint management (AFES) on the ultimate ROM of the replaced knees using mainly Tricon-M and Miller-Galante prostheses were studied. A total of 161 TKAs in III patients were performed. The mean preoperative and postoperative final ROM were 105.2° ± 13.4° and 115.1° ± 14.7°. In 74 rheumatoid arthritis (RA) knees, the final mean ROM was 107.6° ± 13.7°; in 87 osteoarthritis (OA) knees, the final mean ROM was 123.1°± 14.9°. The final mean ROM of the splinted knees was significantly greater than that of the CPM group, and the subvastus approach provided a little wider ROM than the medial parapatellar approach. The type of implant did not influence the final ROM of the replaced knees when the same postoperative rehabilitation program was provided. It was confirmed that postoperative application of the alternate flexion and extension splintage on the operated knee is the most reliable and effective method of restoring wider ROM following TKA.