Knee stiffness on extension caused by an oversized femoral component after total knee arthroplasty: A report of two cases and a review of the literature

Two patients experiencing knee stiffness on extension subsequent to total knee arthroplasties (TKAs) are reported on in this paper. The use of an oversized femoral component is suggested as the main cause of the stiffness. Revision surgery using a smaller femoral component and resecting more bone from the posterior aspect of the distal femur than during initial TKA surgery was performed to expand the joint’s flexion gap without affecting joint stability on extension. This procedure appeared to solve the pre-existing limitation in knee flexion experienced by both patients subsequent to the first TKA. This complication appears to be rarely referred to in the literature: we report on 2 such cases in this paper. The range of motion in the first case was from 5° to 33° before revision surgery. After revision, the range of motion improved to 0°/90°. The second case improved from 0°/45° to 0°/110°.