Jeffrey Rocco1, David Putzer2, Michael Nogler2, Alexandra Rocco3, Paul Maitino4, Martin Thaler5. 1. Utah Orthopaedics, 5782 Adams Avenue Parkway, Ogden, UT, 84405, USA. jrocco@utahorthopaedics.com. 2. Department of Orthopaedics-Experimental Orthopaedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria. 3. Utah Orthopaedics, 5782 Adams Avenue Parkway, Ogden, UT, 84405, USA. 4. Joint Reconstructive Specialists, Inc., 3110 SW 89th Street Suite 200D, Oklahoma City, OK, 73159, USA. 5. Department of Orthopaedics, Medical University of Innsbruck, Innrain 36, 6020, Innsbruck, Austria.
Abstract
INTRODUCTION: Flexion contracture in knee arthritis and total knee arthroplasty (TKA) is a common and significant problem. An improvement in knee extension in patients with TKA and mild flexion contractures has been observed clinically when a gastrocnemius recession was performed for other concomitant conditions. The goal of this study was to quantify the effect of gastrocnemius recession on knee flexion in TKA cadaver model. MATERIALS AND METHODS: Range of motion (ROM) of 23 cadaveric knees was determined with a navigation system before and after performing TKA using a medial parapetallar approach and after performing a gastrocnemius recession. Varus-valgus, flexion-extension, and internal-external rotation angles of the knee joint were recorded with leg in full extension and in 90°of knee flexion. Extension and flexion gaps were measured using a gap tensioning device. Dorsiflexion of the foot was measured with a goniometer when a torque moment of 10 Nm was applied to the ankle joint. RESULTS: A statistically significant improvement of 5° in knee extension was observed following gastrocnemius recession (P = 0.015). Varus and valgus angles, internal, and external rotation were unaffected by gastrocnemius recession. Ankle dorsiflexion increased by 9° following gastrocnemius recession (P ≤ 0.001). CONCLUSIONS: Performing a gastrocnemius recession improves the knee extension in TKA knees with flexion contractures. Gastrocnemius recession may be a useful technique to improve terminal extension in TKA.
INTRODUCTION: Flexion contracture in knee arthritis and total knee arthroplasty (TKA) is a common and significant problem. An improvement in knee extension in patients with TKA and mild flexion contractures has been observed clinically when a gastrocnemius recession was performed for other concomitant conditions. The goal of this study was to quantify the effect of gastrocnemius recession on knee flexion in TKA cadaver model. MATERIALS AND METHODS: Range of motion (ROM) of 23 cadaveric knees was determined with a navigation system before and after performing TKA using a medial parapetallar approach and after performing a gastrocnemius recession. Varus-valgus, flexion-extension, and internal-external rotation angles of the knee joint were recorded with leg in full extension and in 90°of knee flexion. Extension and flexion gaps were measured using a gap tensioning device. Dorsiflexion of the foot was measured with a goniometer when a torque moment of 10 Nm was applied to the ankle joint. RESULTS: A statistically significant improvement of 5° in knee extension was observed following gastrocnemius recession (P = 0.015). Varus and valgus angles, internal, and external rotation were unaffected by gastrocnemius recession. Ankle dorsiflexion increased by 9° following gastrocnemius recession (P ≤ 0.001). CONCLUSIONS: Performing a gastrocnemius recession improves the knee extension in TKA knees with flexion contractures. Gastrocnemius recession may be a useful technique to improve terminal extension in TKA.
Authors: Robert B Bourne; Bert M Chesworth; Aileen M Davis; Nizar N Mahomed; Kory D J Charron Journal: Clin Orthop Relat Res Date: 2010-01 Impact factor: 4.176
Authors: Sebastian F Baumbach; Mareen Brumann; Jakob Binder; Wolf Mutschler; Markus Regauer; Hans Polzer Journal: BMC Musculoskelet Disord Date: 2014-07-23 Impact factor: 2.362