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Essay On Flexion Contracture

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Introduction: Flexion contracture (FC) is a commonly encountered deformity in patient undergoing total knee arthroplasty (TKA). Hemophilic arthropathy of the knee joint is the most common joint involvement in patients with hemophilia which often leads to FC. Clinical course of FC after replacement of an osteoarthritic knee is well reported in the literature. However, to our experience in a high volume referral center, the course may be different in patients with hemophilic arthropathy.

Objectives: The purpose of this study was to define the clinical course of flexion contracture after TKA in patients with haemophilia.

Methods: Between April 2010 and April 2014, 65 patients with haemophilic arthropathy and flexion contracture were enrolled and underwent TKA. Intraoperatively, we employed usual soft tissue and bony techniques for management of flexion deformity. Postoperatively, all the patients passed a course of supervised physical therapy emphasizing on muscle
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The mean age of the patients was 36.5±8.4. The knee society score, WOMAC and SF36 quality of life scores had been significantly improved at 12 months post-surgery. The mean preoperative flexion contracture (27.6±11.2) was significantly corrected (14.2±6.2) at the end of the procedure (p<0.05). The largest part of the residual deformity improved within 6 months of surgery.

Conclusions: According to our data, we believe residual on-table postoperative flexion contracture after TKA in haemophilic knees can significantly improve over time. Our findings, is in contrast to most studies on osteoarthritic patients where flexion contracture tend to persist and complete intraoperative correction of the deformity is advised. The different pathophysiology of the disease, as well as, the age and activity level of the patients may have a role in this regard. Supervised protocol for physical therapy can also be of utmost
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