Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2015

01-06-2015 | Knee

Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty

Authors: Zhihong Zhou, Khye Soon Andy Yew, Earnest Arul, Pak-Lin Chin, Keng Jin Darren Tay, Ngai-Nung Lo, Shi-Lu Chia, Seng Jin Yeo

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2015

Login to get access

Abstract

Purpose

The primary aim of this study was to identify the time point at which improvements in knee range of motion reach a plateau, if any. The secondary aim of this study was to investigate the correlation between the improvements in knee range of motion and patient-reported outcomes [Oxford knee score (OKS) and SF-36]. The hypothesis is that there is a time point at which the recovery in the knee range of motion after total knee arthroplasty (TKA) plateaus.

Method

A prospective study of 145 patients who underwent TKA was conducted. All TKAs were performed by the same surgeon. OKS and SF-36 scores were measured preoperatively and at 6, 12, and 24 months. Range of motion was measured preoperatively and at 1, 3, 6, 12, and 24 months postoperatively.

Results

This study shows that for surgeon/therapist reported range of motion, a plateau in recovery was reached at 12 months after TKA. It was also found that range of extension is significantly correlated with OKS, whereas range of flexion was not significantly correlated with OKS.

Conclusions

Knowledge of when patients fully recover after TKA will allow appropriate counseling of patients during preoperative consultation. Also, this knowledge will enable surgeons/therapists to better monitor the rehabilitation progress of TKA patients, and make adjustments to the rehabilitation protocol. In addition, our study shows that objective surgeon-/therapist-measured outcome (range of motion) has a significant correlation with subjective patient-reported outcomes (OKS). Hence, both outcome measures should be employed in the postoperative monitoring of patient progress.

Level of evidence

Prospective case series, Level IV.
Literature
1.
Chiu KY, Ng TP, Tang WM, Yau WP (2002) Review article: knee flexion after total knee arthroplasty. J Orthop Surg (Hong Kong) 10(2):194–202
2.
Harato K, Bourne RB, Victor J, Snyder M, Hart J, Ries MD (2008) Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the genesis II prosthesis. A multicenter prospective randomized clinical trial. Knee 15(3):217–221CrossRefPubMed
3.
Ishii Y, Noguchi H, Takeda M, Sato J, Toyabe S (2011) Prediction of range of motion 2 years after mobile-bearing total knee arthroplasty: PCL-retaining versus PCL-sacrificing. Knee Surg Sports Traumatol Arthrosc 19(12):2002–2008CrossRefPubMed
4.
Jacobs WC, Clement DJ, Wymenga AB (2005) Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop 76(6):757–768CrossRefPubMed
5.
Khatri D, Malhotra R, Bhan S, Kumar V, Eachempati KK (2009) Comparison of total knee arthroplasty in stiff knees and knees with good preoperative range of motion. J Knee Surg 22(4):305–309CrossRefPubMed
6.
Kim TK, Choi J, Shin KS, Chang CB, Seong SC (2008) Patients’ perspective on controversial issues in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 16(3):297–304CrossRefPubMed
7.
Ko Y, Lo NN, Yeo SJ, Yang KY, Yeo W, Chong HC, Thumboo J (2013) Comparison of the responsiveness of the SF-36, the Oxford knee score, and the knee society clinical rating system in patients undergoing total knee replacement. Qual Life Res. doi:10.​1007/​s11136-013-0376-y PubMed
8.
Lenssen AF, van Dam EM, Crijns YH, Verhey M, Geesink RJ, van den Brandt PA, de Bie RA (2007) Reproducibility of goniometric measurement of the knee in the in-hospital phase following total knee arthroplasty. BMC Musculoskelet Disord 8:83CrossRefPubMedCentralPubMed
9.
Maruyama S, Yoshiya S, Matsui N, Kuroda R, Kurosaka M (2004) Functional comparison of posterior cruciate-retaining versus posterior stabilized total knee arthroplasty. J Arthroplast 19(3):349–353CrossRef
10.
Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN (2003) Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplast 18(3):286–294CrossRef
11.
Mizner RL, Petterson SC, Snyder-Mackler L (2005) Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther 35(7):424–436CrossRefPubMed
12.
Murray DW, Fitzpatrick R, Rogers K, Pandit H, Beard DJ, Carr AJ, Dawson J (2007) The use of the Oxford hip and knee scores. J Bone Joint Surg Br 89(8):1010–1014CrossRefPubMed
13.
Naylor JM, Yeo AE, Mittal R, Ko VW, Harris IA (2012) Improvements in knee range and symptomatic and functional behavior after knee arthroplasty based on preoperative restriction in range. J Arthroplast 27(6):1100–1105CrossRef
14.
Nilsdotter AK, Toksvig-Larsen S, Roos EM (2009) Knee arthroplasty: are patients’ expectations fulfilled? A prospective study of pain and function in 102 patients with 5-year follow-up. Acta Orthop 80(1):55–61CrossRefPubMedCentralPubMed
15.
Quah C, Swamy G, Lewis J, Kendrew J, Badhe N (2012) Fixed flexion deformity following total knee arthroplasty. A prospective study of the natural history. Knee 19(5):519–521CrossRefPubMed
16.
Scott CE, Howie CR, MacDonald D, Biant LC (2010) Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br 92(9):1253–1258CrossRefPubMed
17.
18.
Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30(6):473–483CrossRefPubMed
19.
Winemaker M, Rahman WA, Petruccelli D, de Beer J (2012) Preoperative knee stiffness and total knee arthroplasty outcomes. J Arthroplast 27(8):1437–1441CrossRef
20.
Zeger SL, Liang KY, Albert PS (1988) Models for longitudinal data: a generalized estimating equation approach. Biometrics 44(4):1049–1060CrossRefPubMed
Metadata
Title
Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty
Authors
Zhihong Zhou
Khye Soon Andy Yew
Earnest Arul
Pak-Lin Chin
Keng Jin Darren Tay
Ngai-Nung Lo
Shi-Lu Chia
Seng Jin Yeo
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3212-1

Other articles of this Issue 6/2015

Knee Surgery, Sports Traumatology, Arthroscopy 6/2015 Go to the issue

Knee

Does patellar denervation reduce post-operative anterior knee pain after total knee arthroplasty?

Knee

Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome?

Knee

Deep-dished highly congruent tibial insert in CR-TKA does not prevent patellar tendon angle increase and patellar anterior translation

Knee

Predictive factors of length of hospital stay after primary total knee arthroplasty

Knee

Intraoperative ligament laxity influences functional outcome 1 year after total knee arthroplasty

Knee

The influence of body mass index on the outcomes of primary total knee arthroplasty