Total knee arthroplasty in the stiff or ankylosed knee is an extremely demanding technical procedure (Fig. 4). The challenge begins in the work-up and evaluation of these patients by assessing the cause of their stiffness and the degree to which it interferes with activities of daily living. Preoperative planning directs surgical management by deciding which type of surgical exposure is utilized, and whether a custom prosthesis is necessary based upon clinical and radiographic examinations. Surgical performance is centered on the same principles as in less challenging primary cases: adequate exposure, soft tissue balancing of symmetric flexion and extension gaps, maintenance of the joint line, and proper patellofemoral kinematics. Prior studies have detailed the results, as well as the complications of this procedure. These experiences have shown that in the properly indicated patients, successful results can be achieved through careful surgical technique and adherence to an aggressive postoperative physical therapy protocol.
KeywordsTotal Knee Arthroplasty Joint Line Reflex Sympathetic Dystrophy Soft Tissue Balance Stiff Knee
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