Range of Motion After Arthroplasty for the Stiff Osteoarthritic Knee

In 28 of 1656 total knee arthroplasties (TKAs) (1.7%) performed for osteoarthritis at this institution, the preoperative arc of motion was 60° or less (average 47.5°; range, 20–60°). The outcome of 22 of the 28 TKAs (21 patients) is reported at a mean follow-up of 52.9 months (range, 24–144 months). Eighty-two percent of the cases were managed with standard soft-tissue releases and posterior cruciate-retaining implants and 18% with a cruciate-substituting design. The joint score rose from 28.8 to 82.2 and the Knee Society Score from 24.6 to 77 points. The mean postoperative arc of motion improved by 46° –93.5°. At latest follow-up, 68.2% of knees achieved maximal flexion of 90° or more. Manipulation was performed in 22.7%. Complications were minimal. A functionally useful range of motion is possible after total knee arthroplasty in the majority of stiff osteoarthritic knees, often without the need for posterior cruciate substitution. (Journal of the Southern Orthopaedic Association 11(4):227–230, 2002)