Surgical treatment of flexion contractures after total knee arthroplasty

The goal of knee arthroplasty is to relieve pain and normalize range of motion while providing stability through the gait cycle. Postoperative, significant (>15 degrees) flexion contractures can cause persistent pain and altered gait mechanics. This study evaluated the efficacy of revision surgery for painful flexion contractures. Of the 14 patients included in the study, 10 had complete resolution of their flexion contracture. There was significant improvement in extension (P < .0001), flexion (P = .002), and total arc of motion (P < .0001). Knee Society (KSS) pain scores improved significantly (P < .001), whereas KSS function scores did not significantly improve (P = .66). Revision surgery for symptomatic flexion contractures can improve range of motion and diminish pain. The best form of treatment is avoidance through careful flexion and extension gap balancing during primary surgery.