Flexion Following TKR

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I had trouble viewing that link but found it on the PubMed website: http://www.ncbi.nlm.nih.gov/pubmed/23027482

It really is not surprising that different approaches get a different reading. When I was struggling for flexion, my heart was set on getting 90 degrees, and anything beyond that was heavenly. You can eyeball that much!
 
Thanks for posting this. Interesting to see how things are a couple of years down the road. Makes me even more pleased with the flexion I'm getting. :)
 
Another bit on range of movement following knee replacement:

Measured Flexion Following Total Knee Arthroplasty
Kenny T. Mai, MD; Christopher A. Verioti, DO; Mary E. Hardwick, MSN; Kace A. Ezzet, MD; Steven N. Copp, MD; Clifford W. Colwell Jr., MD
Abstract
Postoperative flexion is an important factor in the outcome of total knee arthroplasty. Although normal activities of daily living require a minimum of 105° to 110° of flexion, patients from non-Western cultures often engage in activities such as kneeling and squatting that require higher flexion. The desire to achieve greater flexion serves as the driving force for prosthetic modifications, including high-flexion designs. Techniques used to measure knee flexion and knee position during measurement are not often described or are different depending on the examiner. The purpose of this study was to compare active (self) and passive (assisted) flexion after successful total knee arthroplasty for 5 prostheses (2 standard and 3 high-flexion) using clinical (goniometer) and radiographic (true lateral radiograph) measurement techniques by different independent examiners.
At a mean follow-up of 2.7 years (range, 1–5.6 years), a total of 108 patients (144 total knee arthroplasties) had completed the study. Mean postoperative active flexion was 111° clinically and 109° radiographically for the standard designs and 114° clinically and 117° radiographically for the high-flexion designs. Adding passive flexion increased flexion to 115° clinically and 117° radiographically for the standard designs and 119° clinically and 124° radiographically for the high-flexion designs. Flexion differences between the 2 measurement techniques (active vs passive and clinically vs radiographically) were statistically significant (P<.05). These findings demonstrate the importance of describing how flexion is measured in studies and understanding how the method of measurement can affect the findings.
Dr Mai is from Hanford Community Medical Center, Hanford, Ms Hardwick and Dr Colwell are from Shiley Center for Orthopaedic Research and Education, and Drs Ezzet, Copp, and Colwell are from the Division of Orthopaedics, Scripps Clinic, La Jolla, California; and Dr Verioti is from McLaren Regional Medical Center, Flint, Michigan.
Drs Mai, Verioti, Ezzet, and Copp and Ms Hardwick have no relevant financial relationships to disclose. Dr Colwell is a consultant for Medical Compression Systems Inc and Stryker and receives NIH grant funding for other projects.
Correspondence should be addressed to: Clifford W. Colwell Jr, MD, Shiley Center for Orthopaedic Research and Education, Scripps Clinic, 11025 N Torrey Pines Rd, Ste 200, La Jolla, CA 92037 ([email protected]).
Total knee arthroplasty (TKA) restores function, corrects deformity, and reduces pain associated with end-stage arthritis. Postoperative flexion is an important factor in determining patient satisfaction after TKA. Postoperative flexion tends to stabilize by 12 months postoperatively, with little change beyond that point according to previous reports.7–11 Knee flexion is integral to functions in activities of daily living. Although normal activities of daily living require a minimum of 105° to 110° of flexion, patients of non-Western cultures often engage in activities such as kneeling and squatting that require higher flexion.12,13 The desire to achieve greater flexion serves as the driving force for prosthetic modifications, including high-flexion designs.
Techniques used to measure knee flexion and the position of the knee during measurement are not often described and are different depending on the examiner. Comparison of flexion among prostheses is difficult when methods of measurement are inconsistent, which may explain some of the discrepancy in postoperative flexion, ranging from 103° to 139°, reported in the literature. With the advent of the high-flexion design knee prosthesis, the method of measurement becomes increasingly important.
The purpose of this study was to compare active (self) and passive (assisted) flexion after successful TKA for 5 prostheses using clinical (goniometer) and radiographic (true lateral radiograph) measuring techniques performed by 3 independent examiners (K.T.M., C.A.V., C.W.C.) who were blinded to the other examiners’ findings.
 
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