Factors affecting early knee-flexion range of motion after total knee arthroplasty.
Yuki Hasebe, Kiyokazu Akasaka, Mitsuru Yamamoto
PMID 34539072WHAT IT FOUND
Patients who could flex their knee more before surgery, had better quadriceps strength after surgery, and had slower pre-op walking tests were more likely to reach 110 degrees of flexion two weeks after total knee replacement.
Pre-op stiffness and post-op muscle weakness were key barriers.
Key findings
01Preoperative knee flexion range of motion, preoperative femorotibial angle, preoperative Timed Up & Go test time, and postoperative knee-extensor strength were independently associated with achieving 110 degrees of knee flexion 14 days after total knee arthroplasty.
02Patients who achieved the 110-degree flexion target had significantly greater preoperative knee range of motion and significantly greater postoperative knee-extensor strength compared to those who did not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was retrospective and conducted at a single facility, which limits generalizability. The sample size was small (99 patients). Knee-extensor strength was measured using manual muscle testing, which is less precise than dynamometry. The study only assessed outcomes at 14 days, so it does not predict long-term range of motion.
Declared interests
The authors declare no conflict of interest.
The easy way to misread this
Do not assume that improving preoperative range of motion or postoperative strength will guarantee achieving 110 degrees of flexion. This study identifies associations, not causation, and the effect sizes are modest. Furthermore, these findings apply to early postoperative recovery (14 days), not long-term outcomes.