Correcting flexion contractures: getting it straight.

Many factors play a role in causing a flexion contracture associated with TKA. The final goal of correction is to achieve and maintain a contracture that is < 15 degrees. Contractures between 10 degrees and 15 degrees may still be symptomatic, and those < or = 10 degrees are rarely a problem. Perioperative and intraoperative treatment measures exist to alleviate flexion contractures. Intraoperative correction determines the final result in most cases, except in inflammatory cases where the preoperative contracture is > 40 degrees. In these cases, under anesthesia the preoperative contracture need only be corrected to within one-third of its initial amount, and the remainder will usually resolve with postoperative physical therapy and serial casting or splinting.