KNEE CLOSURE IN TOTAL KNEE REPLACEMENT - A RANDOMIZED PROSPECTIVE TRIAL

A randomized prospective study of 75 total knee replacements in 64 pat ients who were randomized to capsular closure with the knee in full ex tension or in flexion was done, Thirty-one knees received a posterior cruciate ligament retaining prosthesis and 44 knees received a posteri or stabilized prosthesis, Preoperatively, there was no significant dif ference between the groups, and patients were stratified by surgeon an d type of prosthesis, Postoperatively, all patients were evaluated by a physical therapist who did not know the type of prosthesis the patie nt received, In addition to the range of motion obtained at discharge; the number of days required to achieve unassisted transfer; the numbe r of days required to achieve assisted and unassisted use of a walker, cane, and stairs; and the number of days to discharge from the hospit al were recorded. All patients were also evaluated at 2 to 3 months po stoperatively, and the Knee Society clinical rating system scores were compared. There ,vas no statistically significant difference in any o f the early rehabilitation parameters or in the 2- to 3-month followup data. Moreover, there was no statistically significant difference in the rate of complications, With stratification according to the type o f prosthesis used or the surgeon performing the operation, there was s till no statistically significant difference in any of the studied par ameters. It was therefore concluded that the degree of knee flexion at the time of capsular closure in total knee replacement has no effect on early rehabilitation after total knee replacement.