Abstract
The purpose of this study is to investigate the feasibility of surgical correction of moderate flexion deformity during total knee arthroplasty by recreating the posterior condylar recess following certain sequence of surgical principles without extra-resection of bone from the distal femur or proximal tibia. The hypothesized surgical protocol was applied in 52 consecutive primary TKAs with moderate flexion deformity. Preoperative and residual postoperative flexion deformity was recorded. Intraoperatively, extension and flexion gap widths were recorded before and after surgical correction. Fixed flexion deformity has improved from a preoperative mean value of 24.8±6.4 to a postoperative residual value of 3.2±1.8 (p value < 0.001). Extension and flexion gap widths have increased by a mean value of 3.8±0.4 mm and 4.1±0.7 mm respectively (p value < 0.005). There was no significant difference between the changes in the extension and flexion gaps. The original flexion/extension gap width mismatch (3.2±0.5mm) was compensated for by an upsized femoral component. The statistically significant changes has demonstrated the efficiency of the hypothesized surgical protocol for management of flexion deformity during TKA added to the benefits of bone conservation for future revision surgery, preservation of surface area for collateral attachments, and establishment of the joint line at the correct level.
