Yonsei Med J http://www.eymj.org Volume 53 Number 4 July 2012
pISSN: 0513-5796, eISSN: 1976-2437
Yonsei Med J 53(4):794-800, 2012
Evaluation of Postoperative Range of Motion and Functional
Outcomes after Cruciate-Retaining and Posterior-Stabilized
High-Flexion Total Knee Arthroplasty
Chang Wook Han, Ick Hwan Yang, Woo Suk Lee, Kwan Kyu Park, and Chang Dong Han
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Received: July 25, 2011
Revised: September 8, 2011
Accepted: September 21, 2011
Corresponding author: Dr. Chang Dong Han,
Department of Orthopaedic Surgery,
Yonsei University College of Medicine,
50 Yonsei-ro, Seodaemun-gu,
Seoul 120-752, Korea.
Tel: 82-2-2228-2180, Fax: 82-2-363-1139
∙ The authors have no financial conflicts of
Yonsei University College of Medicine 2012
This is an Open Access article distributed under the
terms of the Creative Commons Attribution Non-
Commercial License (http://creativecommons.org/
licenses/by-nc/3.0) which permits unrestricted non-
commercial use, distribution, and reproduction in any
medium, provided the original work is properly cited.
Purpose: The purpose of this study was to compare postoperative range of motion
and functional outcomes among patients who received high-flexion total knee ar-
throplasty using cruciate-retaining (CR-Flex) and posterior-stabilized (PS-Flex)
type prostheses. Materials and Methods: Among 127 patients (186 knees) who
underwent high-flexion total knee arthroplasty between 2005 and 2007, 92 knees
were placed in the CR-Flex group, and 94 knees were placed in the PS-Flex group.
After two years of postoperative follow-up, clinical and radiographic data were re-
viewed. Postoperative non-weight-bearing range of knee motion, angle of flexion
contracture and functional outcomes based on the Western Ontario and McMaster
Universities Osteoarthritis (WOMAC) functional sub-scale were assessed and
compared between the two groups. Results: After the 2-year postoperative period,
the mean range of motion was 131° in the CR-Flex group and 133° in the PS-Flex
group. There were no significant differences in postoperative range of motion be-
tween the two groups. Only age at operation and preoperative range of motion
were significantly associated with postoperative range of motion after high-flexion
total knee arthroplasty. Postoperative functional outcomes based on the WOMAC
functional sub-scale were slightly better in the CR-Flex group (9.2±9.1 points)
than in the PS-Flex group (11.9±9.6 points); however, this difference was not sta-
tistically significant (p=non-significant). Conclusion: The retention or substitution
of the posterior cruciate ligament does not affect postoperative range of motion
(ROM) or functional outcomes, according to 2 years of postoperative follow-up of
high-flexion total knee arthroplasty.
Key Words: Total knee arthroplasty, range of motion, functional outcomes, cruci-
ate-retaining, posterior-stabilized, high-flexion
Postoperative range of motion (ROM) is one of the most important factors influ-
encing patient satisfaction after total knee arthroplasty (TKA). Patients planning to
undergo TKA, especially in non-western cultures, usually expect that he or she
will be able to sit cross-legged or kneel with ease after the operation; however,
Chang Wook Han, et al.
Yonsei Med J http://www.eymj.org Volume 53 Number 4 July 2012
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