ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2020
Effect of additional distal femoral resection on flexion deformity in posterior-stabilized total knee arthroplasty.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Intraoperative management of pre-operative flexion contractures using robotic-assisted total knee arthroplasty.Journal of experimental orthopaedics · 2026Article
- Robotic quantification of the mechanical effect of corrective manoeuvres for intraoperative extension deficiency in total knee arthroplasty: A cadaveric study.Journal of experimental orthopaedics · 2026Article
- The effectiveness of surgical management in knee flexion contracture in primary total knee arthroplasty.Pakistan journal of medical sciences · 2026Article
- Airplane Test: An Intraoperative Assessment for Flexion Contracture in Total Knee Arthroplasty.Arthroplasty today · 2025Article
- Image-based robotic total knee arthroplasty preserves the knee joint line level even in advanced fixed flexion deformities when combined with functional alignment principles: A retrospective comparative cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Developing a Machine-Learning Predictive Model for Retention of Posterior Cruciate Ligament in Patients Undergoing Total Knee Arthroplasty.Orthopaedic surgery · 2024Article
- Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review.SICOT-J · 2024Article
- Fixed Flexion Contracture Can Successfully Be Addressed with Exact Preservation of the Femoral Joint Line and Only Minimal Increase of Tibia Resection in the Concept of Kinematically Aligned Total Knee Arthroplasty.Journal of personalized medicine · 2023Article
- Additional Distal Femoral Resection Minimally Improves Terminal Knee Extension: A Systematic Review and Meta-Regression Challenging the Dogma.Arthroplasty today · 2023Article
- Correlation between component alignment and short-term clinical outcomes after total knee arthroplasty.Frontiers in surgery · 2022Article
- Efficacy of posterior capsular release for flexion contracture in posterior-stabilized total knee arthroplasty.Journal of experimental orthopaedics · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFlexion deformity after total knee arthroplasty (TKA) is associated with poor function and dissatisfaction and should, therefore, be avoided. In the case of preoperative flexion deformity, an increased distal resection of the femur may be necessary. The degree of resection required has only been determined for cruciate-retaining (CR) prostheses to date and varies considerably from study to study. Although, for many surgeons, the algorithm for the treatment of a flexion deformity includes the resection of the posterior cruciate ligament (PCL) before additional distal resection, the degree of resection necessary for posterior-stabilized (PS)-type prostheses is not known.
methodsFifty consecutive patients (50 knees) who were due to undergo navigated TKA were included in this prospective study. At the end of the operation, the flexion deformity resulting from different sizes of distal femoral augmentations on the trial implants (0-8.5 mm) was determined using the navigation system.
resultsA linear relationship of 2.2° ± 0.3° flexion deformity per mm distal femoral augmentation was found. This was not dependent on age, sex, the preoperative coronal alignment, or the preoperative flexion deformity.
conclusionsIn conclusion, after the removal of posterior osteophytes and posterior capsule release, around 5 mm of the distal femur must be further resected in the case of 10° flexion deformity and 9 mm in the case of 20° flexion deformity. LEVEL OF EVIDENCE: II (Prospective cohort study).
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