N°276 - August/September 2018
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Stiffness after total knee arthroplasty epidemiology: causes and decision-making
By C. Debette in category UPDATE
Clinique de l'Infirmerie Protestante Lyon Caluire
A. Introduction - Definition - Epidemiology
Knee stiffness is defined as a limited range of movement in the joint. When it occurs after a total knee arthroplasty, it accounts for 14.3% of revisions, behind loosening and sepsis (SOFTCOT 2011). This finding is corroborated in the literature.1–4 Stiffness is also a common cause of early rehospitalization.5
Average flexion after total replacement surgery ranges from 105° to 120°, depending on the series. A range of motion of 0°–110° is satisfactory.6 However, there is no consensus as to the definition of stiffness in terms of range of movement. In addition, it can vary over time, for up to three years post-surgery.7,8 This makes the prevalence of knee stiffness post-arthroplasty hard to assess, since it ranges between studies from 1.3% to 12%9–11, depending on the definition of the stiffness and the length of follow-up.
There are three categories of stiffness: flexion contractures, extension contractures and combined contractures, which involve both of the first two types. The stiffness is often accompanied by pain due to the increased muscle strain and effort needed to perform daily activities, especially in the extensor mechanism.12,13
It results in a functional deficit, the extent of which depends on the degree of stiffness12,...
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