Total Knee Arthroplasty in Knees with Fixed Flexion Deformity

Abstract

AbstractEnd-stage knee arthritis usually ends up in severe deformities. Correction of these deformities to neutral is prime aim of total knee arthroplasty, giving maximum functional ability to the patient. The flexion deformity, which is the commonest, needs complete correction as it has a significant bearing on the gait of the patient preoperatively as well as post-operatively. Post-operative flexions deformity possesses a challenge to the patient in terms of altered biomechanics of the operated knee joint and progression of disease in contra-lateral knee. Preoperative assessment and planning are very essential for stepwise deformity correction, as under correction can lead to persistent deformity and over correction can lead to unstable knee joint. In the following chapter, we describe the stepwise and severity wise surgical steps and tips of deformity correction. These patients can post-operatively recoil into persistent flexion deformity in the immediate post-operative period and needs some sort of immobilisation of knee in full extension to stretch out the muscle spasm and soft tissue. In spite of all the surgical efforts and post-operative rehabilitation strategies, the deformity can recur and lead to persistent flexion contracture. These patients need manipulation under anaesthesia to get rid of the deformity.KeywordsTotal knee arthroplastyFixed flexion deformity