ArticleJournal of orthopaedics
Large osteophyte removal from the posterior femoral condyle significantly improves extension at the time of surgery in a total knee arthroplasty.
Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 20 citations in OpenAlex.
- Automated CT-based quantification of knee osteophytes for robotic-assisted total knee arthroplasty: a multi-cohort study.Journal of robotic surgery · 2026Article
- Posterior Osteophyte Resection from the Medial Femoral Condyle Increases Medial Gap of Extension and Mid-Flexion in Total Knee Arthroplasty.Clinics in orthopedic surgery · 2026Article
- Surgical Procedure for Osteophyte Impingement of the Quadriceps Tendon: A Case Report.Journal of orthopaedic case reports · 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
- Discrepancy between predicted and actual soft tissue balance in robot-assisted total knee arthroplasty.Journal of orthopaedics · 2025Article
- Clinical Relevance of Posterior Osteophyte Formation in Ultra-congruent Total Knee Arthroplasty: Midterm Radiographic Rollback and Impingement Analysis.Clinics in orthopedic surgery · 2024Article
- Management of fixed flexion contracture in primary total knee arthroplasty: recent systematic review.SICOT-J · 2024Article
- Clinical relevance of roll-back replacement of ultra congruent total knee arthroplasty: comparison of mid-term outcomes with posterior stabilizing design.Archives of orthopaedic and trauma surgery · 2023Article
- Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm-Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing.Journal of clinical medicine · 2023Article
- Risk factors of de novo hyperextension developed after posterior cruciate ligament substituting total knee arthroplasty: a matched case-control study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Additional Distal Femoral Resection Minimally Improves Terminal Knee Extension: A Systematic Review and Meta-Regression Challenging the Dogma.Arthroplasty today · 2023Article
- Predicting robotic-assisted total knee arthroplasty operating time : benefits of machine-learning and 3D patient-specific data.Bone & joint open · 2022Article
- What is the Effect of Posterior Osteophytes on Flexion and Extension Gaps in Total Knee Arthroplasty? A Cadaveric Study.Arthroplasty today · 2021Article
- The effect of hamstring tightness on intraoperative extension gap in posterior stabilized total knee arthroplasty.Scientific reports · 2021Article
- Surgical procedures for the prevention of extension-flexion gap imbalance in total knee arthroplasty.Journal of orthopaedicsArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Removing osteophytes from the posterior compartment of the femur eliminates the tenting effects on the joint capsule and consequently increases the extension gap in total knee arthroplasty. However, there is no clear association with the size of osteophytes removed and the potential degree of additional extension achieved at time of surgery.
aimsCorrelate the size of posterior osteophytes removed with the degree of extension gained intraoperatively in total knee arthroplasty and develop a radiological classification system to grade these osteophytes.
methodsPatients who underwent a TKA had pre and post operative sagittal radiographs assessed and classified according to 4 different categories of a proposed classification system. Knee extension was then assessed by a computer navigated system before incision and after implant insertion. Confounding factors were controlled and considered on the analysis. The study was done retrospectively.
results147 patients were included in the study. Ninety-three (63.2%) patients had osteophytes on the posterior aspect of the femur completely removed and fifty-four patients (36.8%) did not have radiological evidence of osteophytes on the posterior aspect of the femur. There was a positive and linear correlation (Pearson correlation 0.327, p .005) between osteophyte size and degree of extension corrected at time of surgery. On Multivariate Logistic Regression Analysis, we found that small osteophytes (Grade 1) did not seem to affect the extension, while removing Grade 2 or Grade 3 osteophytes lead to a gain in extension of 2.7 and 4.5° respectively.
conclusionRemoving large osteophytes (Grade 2 and Grade 3) from the posterior femoral compartment can be used as an adjuvant strategy to ensure that intraoperative extension is optimal. However removing small osteophytes (Grade 1) should not be expected to affect extension at the time of surgery in TKA and could increase intra-operative time and morbidity.
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