Article

OBJECTIVE: To (1) identify demographic and clinical factors associated with knee
flexion contracture (KFlC) in the setting of osteoarthritis (OA) and (2)
histologically compare the posterior knee capsule of patients with OA with and
without KFlC. DESIGN: Cross-sectional study. SETTING: Primary care, including
private and institutional practice. PATIENTS: Thirteen patients with primary OA
and KFlC and 8 patients with primary OA without KFlC. METHODS: We compared the
KFlC and non-KFlC groups to identify demographic and clinical factors associated
with KFlC. We examined the histology of the posterior knee capsules of 9 patients
with KFlC and 6 without. MAIN OUTCOME MEASUREMENTS: Patient demographic and
clinical factors. For histology we measured the proportional composition of
collagenous, adipose, and synovial tissues; fibroblast and adipocyte cellularity;
and synovial thickness. RESULTS: Patients with contracture had longer duration of
OA, reduced flexion of the surgical knee, and reduced extension of the
contralateral knee (P = .04, <.01, and <.01 respectively). Histologically, there
was a greater proportion of collagenous tissue and a lower proportion of adipose
and synovial tissues in the contracture group than in the noncontracture group;
however, the differences were not statistically significant. Cellularity was
similar between the 2 groups. CONCLUSIONS: Longer duration of knee OA, reduced
surgical knee flexion, and reduced contralateral, nonsurgical knee extension were
associated with KFlC in the OA knee undergoing total arthroplasty. Monitoring
bilateral knee range of motion in patients with longer-duration OA could allow
earlier intervention, reducing functional loss. Capsular tissue composition
analysis may indicate a fibrotic disease process. Further research in which a
larger sample size is used will help clarify these novel findings.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS