Surgical closing in total knee arthroplasty - A series followup

The benefits of closing the surgical wound of a primary and revision total knee prosthesis with the knee in full flexion are examined, A previous stud y showed that surgically closing the primary knee arthroplasty with the kne e in full flexion produced significantly more postoperative flexion at 6 mo nths: 114.7 degrees compared with 108.1 degrees, Of 108 selected sequential primary knee arthroplasties, the first 52 knees were closed surgically wit h the leg in full knee extension, and the second 56 knees were closed in 90 degrees to 110 degrees flexion, depending on the available motion of the j oint. The patients in each group were matched closely in age, weight, heigh t, gender, and surgical technique, At all followup intervals, the flexion m easurements were significantly better in the flexion closure group. At 1 ye ar, the flexion group had 117.9 degrees and the extension group had 112.9 d egrees flexion. The revision series also was a selected sequential series w ith 13 knees in each closure group, In the revision case, the 1-year findin gs were similar, with significantly more knee flexion in the flexion closur e group (118.7 degrees compared with 112.7 degrees). In matched groups, fle xion closure in primary and revision knee replacements significantly increa sed total range of motion, as seen at the 1-year Followup.