Factors that Influence Range of Motion after Knee Replacement

Factors that Influence Range of Motion after Knee Replacement

There are three factors that influence the range of motion after a knee replacement. They include the patient, the surgical technique, and the design of the implant. 

Patient-related factors include the preoperative range of motion that that particular patient has, which is probably the single most important factor in determining range of motion after knee replacement. Other patient-related factors include how diligently they work in therapy after surgery, how motivated they are to return to activity, and their level of fitness. 

Surgeon-related factors include the alignment of the limb following surgery and placement of the implants. These factors influence how well the knee can function after recovery from surgery. 

Implant-related factors include the shape and design of the femoral and tibial component as these help determine factors such as roll-back, the degree of flexion allowable, and the articulation of the kneecap against the prosthetic femoral component. 

All of these factors play an important role in the postoperative result but the one that studies have shown influences postoperative range of motion most is the patient’s preoperative range of motion. 

William P. Barrett, M.D.

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Valley Medical Center's Marketing and Community Outreach Office


  1. Loretta Jackson

    I had a total knee replacement January 29, 2007. There was miscommunication from the Doctor and the Hospital which prevented me from starting physical therapy until February 20th, although I was sent home with a CPM unit. I am african american, obese and now have limited range of motion; although I can pedal a bike completely. I worked extremely hard during therapy and never missed one appointment (3x wk) for 5 months. I had a manipulation on April 5th, gained range but was unable to keep it. The doctor tells me I have excessive scar tissue and that there is nothing that can be done. Instead of gaining range the more I worked I seem to lose range. I am extremely stiff and the area above and around my knee is so tight it is almost unbearable. Rather it is unbearable. I am back working but it is extremely different. I only had one knee and still have one bad knee but with results like this I will never have the other knee. Is it true that I have no other recourse but to live with this extreme stiffness and tightness. I feel like someone has wrapped a tourniquet around my entire knee and will not let it go. I have scheduled a second opinion appt but really don’t expect much. Are there specific questions I should ask when seeking the second medical opinion and are doctors typically honest with you when seeking second opinions after the fact?

    Your medical expertise is greatly appreciated.

  2. Dr. William Barrett

    Significant stiffness after a total knee replacement is called Arthrofibrosis. It is one of the most challenging problems after Total Knee Arthroplasty. There are some options with regard to treatment but the outcomes are not totally predictable. 2nd opinions are helpful and docs will give you their honest opinions. Things to check for include implant and leg alignment, implant size and position, kneecap tracking and ligament balance.
    Best Regards,
    Bill Barrett