Total Knee Arthroplasty: Range of Motion across Five Systems

Range of motion after total knee arthroplasty is an important variable in determining clinical outcome. The goal of this study was to assess range of motion across five types of posterior-stabilized knee prostheses used sequentially in the same institution during 17 years. The hypothesis was that absolute flexion would improve in newer models of this basic prosthesis design. Only primary knee arthroplasties in patients with osteoarthritis were evaluated. A retrospective analysis was done. Three hundred fifty-eight knees with osteoarthritis were reviewed. The average arc of motion was 103° before surgery and 111° after surgery. Absolute flexion was clinically similar but improved from before surgery (110°) to after surgery (113°). No difference was found when comparing improvements in range of motion among the different types of prostheses used. This study did not show that any knee system made a difference in determining the final range of motion postoperatively. Height emerged as a predictive factor of absolute flexion. Preoperative range of motion is the most important variable in determining improvements in range of motion, with height playing a secondary role.

Level of Evidence: Prognostic study, Level II-1