Total Knee Arthroplasty in Stiff Knee

Cho, Woo Shin; Park, Jong Hue; Kim, Jung Min; Oh, Se Kwan

Abstract

PURPOSE: To evaluate the results of TKRA (Total knee replacement arthroplasty)for the treatment of stiff knee.
METHODS
& MATERIALS: TKRA has been performed for 18 cases of stiff knee ( ROM < 50 degrees ) between January 1994 and December 2000. 16 cases which have been followed up for more than 2 years were analysed. Average follow-up was 3.3 years(2-6 years). 3 were male and 13 were female. The average age was 55.8 years(34-75years). Sequales of infection were most with 6 cases and followed by osteoarthritis (4 cases, 2 cases had been performed arthroscopic debridement) and rheumatoid arthritis (3 cases) and traumatic arthritis (3 cases) in order. TKRA was performed on average 12.2 years (1-40 years) after knee stiffness has been developed. We evaluate the results with ROM, HSS score and complications.
RESULTS
Average ROM was increased from 31.6 degrees(0 degrees-50 degrees) preoperatively to 95.4 degrees(80 degrees-120 degrees) postoperatively. 5 degrees of flexion contracture was present in only 1 case. Average HSS score was improved from 59.6 points preoperatively to 84.6 points postoperatively. The patella tendon was partially ruptured in 1 case during surgery, but by brace application and rehabilitative exercise, ROM was improved to 90 degrees, 1 year post operatively. There were 1 superficial skin infection which was resolved by revision of wound and skin graft, and deep infection in 3 cases, which needed knee fusion finally.
CONCLUSION
TKRA is a good method for improving function in knee stiffness although infection risk is high.