Long-term results of posterior release surgery for severe flexion contracture of the knee in patients with rheumatoid arthritis.

Twelve knees in nine rheumatoid patients with severe flexion contractures were evaluated clinically and roentgenographically for an average of 17.2 years (range, six to 25 years) after posterior release surgery. Preoperatively, the average extension in the 12 knees was 42.5 degrees, and postoperatively it was 10.8 degrees. Even though patients were able to walk postoperatively, the majority had knee pain when they extended their knees soon after surgery. Seven knees required further surgery after correction of the flexion deformity. The average time before reconstructive surgery after posterior release was 11.1 months. In the treatment of severe flexion deformities of the knee in patients with rheumatoid arthritis, posterior release surgery was effective only in correcting the deformity. Posterior subluxation of the tibia, knee pain, and instability occurred soon after surgery. Therefore, patients may require additional reconstructive surgery soon after the posterior release.