Correcting severe flexion contracture with fusiform capsulectomy of posterior capsule during total knee arthroplasty

Int Orthop. 2021 Jun;45(6):1463-1468. doi: 10.1007/s00264-020-04792-7. Epub 2020 Sep 9.


Purpose: This study aimed to evaluate the safety and efficacy of fusiform capsulectomy of posterior capsule in correcting severe flexion contracture during total knee arthroplasty (TKA).

Methods: A retrospective analysis was performed in the patients who had preoperative severe flexion contracture (> 30 degrees) prior to TKA and received fusiform capsulectomy of posterior capsule during TKA between December 2013 and November 2018. Range of motion (ROM), knee functional score, forgotten joint score (FJS), post-operative complications, and radiographic results were collected and evaluated.

Result: Twenty patients (32 knees) were enrolled in this study. The mean duration of follow-up was 27.19 ± 15.92 months. The flexion contracture improved from pre-operative 37.69 ± 11.79° to post-operative 5.78 ± 4.44° (p < 0.001), and ROM increased from pre-operative 63.50 ± 21.74° to post-operative 97.88 ± 13.20° (p < 0.001). KSS clinical score increased from pre-operative 32.94 ± 11.03 to post-operative 82.34 ± 10.73 (p < 0.001), and KSS function score increased from pre-operative 28.97 ± 18.43 to post-operative 68.75 ± 15.96 (p < 0.001). The post-operative FJS was 76.08 ± 2.14. There was no implant loosening, infection, obvious haematoma formation, resultant instability, neurovascular complications, or revision for any reasons in the cohort until the last follow-up.

Conclusions: The technique of fusiform capsulectomy of posterior capsule to correct the severe flexion contracture during primary TKA is safe and effective and could provide good short-term results.

Keywords: Capsulectomy; Knee replacement; Severe flexion contracture.

MeSH terms

  • Arthroplasty, Replacement, Knee* / adverse effects
  • Contracture* / etiology
  • Contracture* / surgery
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Range of Motion, Articular
  • Retrospective Studies
  • Treatment Outcome