Clinical Course of Residual Flexion Contracture After Total Knee Arthroplasty in Patients With Haemophilic Arthropathy
Bibliographic record
Abstract
AIM: This study aims to evaluate the natural course and resolution of flexion contracture following total knee arthroplasty (TKA) in individuals with haemophilic arthropathy. METHODS: Between April 2010 and April 2014, 65 patients with haemophilic arthropathy and preoperative flexion contracture underwent TKA at a single institution. Patients were followed for 56 months (range 48-72 months). Range of motion, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and SF-36 scores were assessed at 3, 6, 12, 24, and 56 months. An intensive physiotherapy protocol included supervised sessions twice weekly for 3 months. RESULTS: Mean age was 34.2 ± 8.3 years. Preoperative flexion contracture of 27.6 ± 11.2° improved to 14.3 ± 6.2° postoperatively, then to 6.9 ± 3.3° at 3 months, 4.4 ± 2.2° at 6 months, 2.2 ± 3.2° at 12 months, and 2.1 ± 3.1° at 56 months (p < 0.001). Patients with clinically significant flexion contracture > 5° decreased from 53 postoperatively (81.5%) to 10 at 3 months (15.4%), 6 at 12 months (9.2%), and 5 at 56 months (7.7%). Multivariate analysis identified immediate postoperative flexion contracture > 15° (OR 8.3, p = 0.002) and age > 40 years (OR 4.1, p = 0.019) as independent predictors of residual contracture > 5° at final follow-up. Final flexion contracture ≤ 5° was achieved in 90.8% at 12 months and maintained in 92.3% at 56 months. CONCLUSIONS: Residual flexion contracture after TKA in haemophilic arthropathy demonstrates significant spontaneous improvement, with 92% correction by 12 months, sustained through 56-month follow-up. This pattern contrasts with commonly reported outcomes in osteoarthritic populations. In haemophilic patients with excellent rehabilitation compliance, surgeons can be confident that mild residual contracture is likely to improve over time.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".