Recovery of knee range of motion after total knee arthroplasty in the first postoperative weeks: poor recovery can be detected early

• Published in: Musculoskeletal surgery Vol. 103; no. 3; pp. 289 - 297
• Main Authors: Kornuijt, A., de Kort, G. J. L., Das, D., Lenssen, A. F., van der Weegen, W.
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.12.2019; Springer; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Analysis; Arthroplasty, Replacement, Knee - adverse effects; Female; Humans; Joint surgery; Knee; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Postoperative Complications; Postoperative Period; Prospective Studies; Range of Motion, Articular - physiology; Recovery (Medical); Recovery of Function; Sensitivity and Specificity; Surgery; Surgical Orthopedics; Time Factors; Tranexamic acid; Total knee arthroplasty; Range of motion; Recovery patterns; Early postoperative
• ISSN: 2035-5106; 2035-5114
• DOI: 10.1007/s12306-019-00588-0

Purpose The aim of this study was to analyze in detail how knee flexion and extension progress in the first 8 weeks after primary total knee arthroplasty (TKA). The secondary goal was to compare knee range of motion (ROM) recovery patterns between patients with normal and delayed ROM recovery 8 weeks after TKA. Methods This prospective clinical trial included all patients who underwent a primary unilateral TKA between February and December 2016 with weekly ROM data documented by the treating outpatient physical therapists ( n  = 137). Goniometry was used to measure knee ROM preoperatively, postoperatively on day 1 and weekly until follow-up at the orthopedic clinic 8 weeks after surgery. ROM recovery patterns were compared between patients with sufficient (≥ 90°) or insufficient (< 90°) knee flexion 8 weeks after TKA. Results Knee flexion recovered from a median of 80° in the first postoperative week to 110° 8 weeks after surgery and knee extension from a mean of − 10.7° to − 3.2°. Recovery was nonlinear, with greatest improvements in the first 4 weeks for knee flexion. In contrast to patients with sufficient knee flexion 8 weeks postoperatively, the insufficient group ( n  = 8, 5.8%) had poor knee flexion on the first postoperative day and from week 4 to week 8 almost no improvement or even worsening of knee flexion. Conclusions Both knee flexion and extension recover in a nonlinear manner after TKA surgery. Poor postoperative knee function can be detected early, using ROM data from the first postoperative day up to the fourth week.