Range of Motion of Standard and High-Flexion Posterior Stabilized Total Knee Prostheses

Background: The restoration of posterior femoral translation has been shown to be an important factor in enhancing knee flexion after total knee arthroplasty. The purpose of this study was to compare the ranges of motion associated with standard and high-flexion posterior stabilized total knee prostheses in patients managed with simultaneous bilateral total knee arthroplasty.

Methods: Fifty patients (mean age, sixty-eight years) received a standard fixed-bearing knee prosthesis in one knee and a high-flexion fixed-bearing knee prosthesis in the contralateral knee. Two patients were men, and forty-eight were women. At a mean of 2.1 years postoperatively, the patients were assessed clinically and radiographically with use of the knee-rating systems of the Knee Society and The Hospital for Special Surgery.

Results: The mean postoperative Hospital for Special Surgery knee score was 90 points for the knees treated with the standard fixed-bearing prosthesis and 89.4 points for those treated with the high-flexion prosthesis. At the time of the final follow-up, the knees with the standard prosthesis had a mean range of motion of 135.8° (range, 105° to 150°) and those with a high-flexion prosthesis had a mean range of motion of 138.6° (range, 105° to 150°) (p = 0.41). No knee had aseptic loosening, revision, or osteolysis.

Conclusions: After a minimum duration of follow-up of two years, we found no significant differences between the groups with regard to range of motion or clinical and radiographic parameters, except for posterior femoral condylar offset.

Level of Evidence: Therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.