O2027 CLOSURE OF KNEE REPLACEMENT WOUND IN FLEXION OR EXTENSION: DOES IT MATTER?

Abstract

Aim: The aim of this study is to assess whether closure of wound in ßexion or extension during total knee replacement has any inßuence on the postoperative range of motion of the knee. Methods: We carried out a prospective randomised study of 58 total knee replacements in 53 osteoarthritic patients. Two senior surgeons performed all the procedures using a cemented IB II posterior stabilised prosthesis. The wound was closed with knee in 60 Ð 70 degrees of ßexion in group A patients and in full extension in group B after deßating the tourniquet. Five Patients underwent bilateral total knee replacements with one closed in ßexion and the other in extension. The incidence of complications, amount of blood loss, length of hospital stay and postoperative range of knee motion were recorded. Results: The mean range of preoperative ßexion was 110 degrees and 104 degrees in the ßexion and extension group respectively. The range of ßexion at the end of one year was 114 degrees in the ßexion group and 106 degrees in extension group. There was no signiþcant statistical difference between the two groups including those with bilateral knee replacements (p> 0.05). Conclusions: Closure of the knee wound in ßexion or extension during total knee replacement has no inßuence on the postoperative range of ßexion at 6 weeks, 6 months and 1 year follow-up. However, the operating surgeons felt that closure in ßexion had an advantage of being haemostatic during closure, but carries a risk of scratching the femoral component while suturing.