Relationship between Perceived Leg Length Discrepancy at One Month and Preoperative Hip Abductor Muscle Elasticity in Patients after Total Hip Arthroplasty

Objective: Preoperative factors related to perceived leg length discrepancy (PLLD) after total hip arthroplasty (THA) are not well studied. This study aimed to examine the preoperative factors, including hip abductor modulus, related to PLLD one month after THA. Methods: The study included 73 patients diagnosed with osteoarthritis secondary to developmental dysplasia of the hip and a posterior approach to surgery. Multiple logistic regression analysis was performed using the presence or absence of PLLD as the dependent variable and preoperative hip abductor''s modulus of elasticity, pain, hip abduction range of motion, hip abductor muscle strength and pelvic obliquity as the independent variable. Additionally, receiver operating characteristic curves were used for the extracted variables for calculating the cutoffs, sensitivity, specificity and area under the curve (AUC) to determine the presence or absence of PLLD. The significance level was set at p<0.05. Results: The hip abductor modulus (odds ratio=1.13; 95% confidence interval=1.06-1.21; p<0.001) was selected as a preoperative factor. The cutoff value to determine the presence or absence of a PLLD was 16.32 kPa. The sensitivity and specificity were 81.8% and 72.5%, respectively, and the AUC was 0.8137. Conclusion: The hip abductor muscle elastic modulus affected PLLD one month after THA. If the preoperative hip abductor elastic modulus is higher than the cutoff value, it may affect the appearance of PLLD at one month postoperatively.     

Isokinetic trunk and knee muscle strengths and gait performance in walking patients with T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP)

The aim of this study was to investigate the isokinetic trunk and knee muscle strengths, and examine the clinical relevance of dynamic muscle strengths and gait performance in walking patients with human T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP). Thirteen patients with HAM/TSP (8 females and 5 males, aged 38–76) and 13 sex- and age-matched healthy control subjects participated in the study. We assessed gait speed, stride length, cadence; and maximal isokinetic torque of trunk and knee extensors and flexors at 30°/s, 60°/s and 90°/s using a Biodex System 3 dynamometer. Furthermore, we calculated the isokinetic trunk extensor/flexor (E/F) and hamstrings/quadriceps (H/Q) strength ratios (parameter of the muscle strength balance about the trunk and knee joint). Compared with the age-matched controls, the patients with HAM/TSP had significantly reduced gait speed, stride length and cadence (P < 0.05). Peak torque values related to body weight (PTBW) were significantly reduced, especially for the knee flexors (P < 0.05). For the knee extensors, the PTBW values were significantly reduced at an increased angular velocity (P < 0.05). The PTBW of knee flexors was positively correlated with gait speed and cadence in the patients with HAM/TSP. The H/Q ratio but not E/F ratio was significantly decreased compared with the control. Our results indicated that the isokinetic trunk and knee muscle performance had reduced from the ambulatory stage, and suggested the deterioration in knee muscle performance to be associated with gait disturbance in walking HAM/TSP patients.     

Changes in diffusion tensor imaging (DTI) eigenvalues of skeletal muscle due to hybrid exercise training

Several studies have proposed the cell membrane as the main water diffusion restricting factor in the skeletal muscle cell. We sought to establish whether a particular form of exercise training (which is likely to affect only intracellular components) could affect water diffusion. The purpose of this study is to characterise prospectively the changes in diffusion tensor imaging (DTI) eigenvalues of thigh muscle resulting from hybrid training (HYBT) in patients with non-alcoholic fatty liver disease (NAFLD). Twenty-one NAFLD patients underwent HYBT for 30 minutes per day, twice a week for 6 months. Patients were scanned using DTI of the thigh pre- and post-HYBT. Fractional anisotropy (FA), apparent diffusion coefficient (ADC), the three eigenvalues lambda 1 (λ1), λ2, λ3, and the maximal cross sectional area (CSA) were measured in bilateral thigh muscles: knee flexors (biceps femoris (BF), semitendinosus (ST), semimembranous (SM)) and knee extensors (medial vastus (MV), intermediate vastus (IV), lateral vastus (LV), and rectus femoris (RF)), and compared pre- and post-HYBT by paired t-test. Muscle strength of extensors (P < 0.01), but not flexors, increased significantly post-HYBT. For FA, ADC and eigenvalues, the overall picture was of increase. Some (P < 0.05 in λ2 and P < 0.01 in λ1) eigenvalues of flexors and all (λ1-λ3) eigenvalues of extensors increased significantly (P < 0.01) post-HYBT. HYBT increased all 3 eigenvalues. We suggest this might be caused by enlargement of muscle intracellular space.     

Incidence of postoperative complications and non- periprosthetic fractures after total hip arthroplasty: A more than 10-year follow-up retrospective cohort study

Objective: Postoperative complications and non-periprosthetic fractures (NPPFs), which was defined as a fracture existing non- periprosthetic implant, after total hip arthroplasty (THA) have a negative effect on the patients'' ability to perform activities of daily living. Thus, investigating these incidences of patients after THA will be valuable as it lead to a more strategic physical therapy interventions and advanced research to prevent these problems. The purpose of this study was to investigate the incidence of postoperative complications related to implants and NPPFs in patients after THA, a more than 10-year follow-up. Methods: This is a retrospective cohort study. A total 892 patients with hip osteoarthritis who underwent primary THA were analyzed (age at surgery was 45-79 years; 805 women; the average follow-up period was 12.4-year). The postoperative complications related to implants and NPPFs were calculated using data from their medical records. Results: The postoperative complications occurred in 37 patients, and NPPFs occurred in 72 patients, who were significantly older, and hip and knee OA diagnosis, compared to patients without NPPFs ( p <.05). The most common cause of NPPFs was minor trauma. In patients aged ≧ 65 years, significantly more NPPFs occurred during the first year after surgery( p <.05). Conclusion: More than 10-year after THA, the incidence of NPPFs was higher than that of postoperative complications related to implants. Older patients who had hip and knee OA were a significantly higher risk of developing NPPFs due to falls within the first year after surgery.     

Relationships between Changes in Oxygenation during Exercise and Recovery in Trained Athletes

The purpose of this study was to investigate the relationships of rate of deoxygenation determined using near-infrared spectroscopy (NIRS) during isometric contraction exercise (Rate_deoxy) with maximal muscle strength, muscle thickness and muscle oxidative capacity of knee extensors in eight well-trained male athletes. The subjects performed sustained isometric extension at 30% and 50% of the maximal voluntary contraction (MVC) load for 10s and 30 repetitive maximal isokinetic knee extensions. Rate_deoxy in the final 5s of 30% MVC was negatively correlated with maximal muscle strength, muscle thickness of knee extensors and the half-time of deoxygenation recovery (T1/2) determined by NIRS after 30 repetitive maximal isokinetic contractions, defined as muscle oxidative capacity. The results suggest that Rate_deoxy during submaximai isometric contraction reflects muscle aerobic capacity.     

Recovery process of respiratory muscle strength in patients following stroke: A Pilot Study

Objective: To determine the recovery process of respiratory muscle strength during 3 months following stroke, and to investigate the association of change in respiratory muscle strength and physical functions. Additionally, we compared respiratory muscle strength with those of healthy subjects. Method: In this prospective, observational study, 19 stroke patients and 19 healthy subjects were enrolled. Maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), motricity index, trunk control test, 6-minute walk test (6MWT) and functional independence measure were assessed at 1, 2, and 3 months from stroke onset in stroke patients. MIP and MEP were assessed at arbitrary times in healthy subjects. Repeated one-way analysis of variance with Bonferroni post-hoc test was used to compare the change in respiratory muscle strength in each period in stroke patients. Pearson''s correlation coefficient was computed for changes in respiratory muscle strength and physical functions. Student''s t-test was used to compare respiratory muscle strength between stroke patients at 3 months from onset and healthy subjects. Results: MIP was significantly increased at 3 months compared to 1 month. MEP was significantly increased in 2 months and 3 months, compared to 1 month. MIP changes associated with 6MWT changes. Compared to healthy subjects, MIP and MEP at 3 months were significantly lower in stroke patients. Conclusion: Respiratory muscle strength significantly increased during 3 months following stroke. However, the trend of recovery may be different. MIP changes may associated with walking endurance changes. During 3 months following stroke, respiratory muscle strength did not recover to healthy subjects.     

Differences in muscle thickness and echo intensity between stroke survivors and age- and sex-matched healthy older adults

Objective: The stroke survivors exhibit change in muscle quantity and quality compared to healthy older adults. This study aimed to compare the muscle thickness (MT) and echo intensity (EI) values of individual muscles between stroke survivors and age- and sex-matched healthy older adults. Methods : In total, 27 stroke survivors and 34 healthy older adults participated in this study. The MT and EI values of the following muscles were assessed from transverse ultrasound images: rectus abdominis (RA), external oblique, internal oblique, transversus abdominis, rectus femoris, vastus intermedius (VI), vastus lateralis (VL), vastus medialis (VM), tibialis anterior (TA), gastrocnemius (Gas), and soleus (Sol). The MT and EI values of these muscles were compared between stroke survivors and healthy older adults. Results : The MT values of the VL, VM, and RA on the non-paretic sides were significantly higher and those of the TA, Gas, and Sol on the paretic sides were significantly lower in the stroke survivors than in the healthy older adults (P < 0.05). The EI values of the VI, VL, VM, TA on the paretic sides and those of the Gas on both the paretic and non-paretic sides were significantly higher in the stroke survivors than in the healthy older adults (P < 0.05). Conclusion : Stroke survivors seem to develop muscle hypertrophy of the non-paretic thigh muscles owing to a compensatory strategy. In addition, the lower-leg muscles on the paretic side of stroke survivors tend to show both quantitative and qualitative muscle changes.     

Morphological and histological effects on the medial pterygoid muscle after unilateral exodontia in gerbils

Morphological effects on the medial pterygoid muscle were evaluated in 20 male gerbils (average weight, 55g) after occlusal alterations induced by extraction of left side molar teeth. Controls were only submitted to surgical stress. Sixty days after surgery, the groups were divided into two subgroups for the following studies: (1) observation of macroscopic morphology and vessels distribution (n=10); (2) light microscopy histological analysis (n=10). Group results were statistically compared using the Wilcoxon and Mann-Whitney tests, with a significant value of p<0.05. Statistical differences in biometric data were found between the left and right sides of the experimental group (p=0.043), and between the left side of the control group when compared to the same side in the experimental group (p=0.044). Vessels supplied by bundles of the external carotid artery in the medial pterygoid muscle did not show distribution differences in group comparisons. Histological alterations were found in the ipsilateral side of the experimental group, with a central localization of the nucleus and degenerative aspect of the fibers, usually near to internal aponeurosis. Fiber diameters seemed reduced and the neuromuscular spindles were localized near internal aponeurosis and had a modified appearance. It is concluded that the medial pterygoid muscle in the gerbil is sensitive to alterations of the masticatory movements.     

Effect of types of proximal femoral fractures on physical function such as lower limb function and Activities of Daily Living

Objectives: This study aimed to assess physical function such as lower limb function and Activities of Daily Living after surgery for proximal femoral fractures ( unstable medial femoral neck fracture and trochanteric fracture). Methods: This study enrolled 68 patients with proximal femoral fractures. Isometric knee extension strength (IKES), the Japanese Orthopedic Association (JOA) hip score, and the number of days required to develop straight leg raising, transfer, and T-caneassisted gait abilities to become independent were assessed. Patients were classified based on the types of proximal femoral fractures, namely unstable medial femoral neck fracture (bipolar hip arthroplasty [BHA] group), stable trochanteric fracture (S group), and unstable trochanteric fracture (US group). Results: IKES and the JOA hip score were significantly better in the BHA group than in the S and US groups. IKES and the JOA hip score were significantly worse in the US group than in the BHA and S groups. Both transfer and T-cane-assisted gait abilities of patients in the BHA and S groups were indifferent. However, all physical functions were significantly worse in the US group. Conclusions: Our study results suggested that physical therapists plan the different rehabilitation program for the patients with proximal femoral fractures who were classified into three types, namely unstable medial femoral neck fracture, stable trochanteric fracture, and unstable trochanteric fracture, instead of two types.     

Effect of Intradialytic Supine Ergometer Exercise on Hemodialysis Patients with Different Nutritional Status

Objective: It is important for hemodialysis patients to exercise while their nutritional status is being monitored. This study aimed to examine the difference in physical exercise function and the effect of exercise intervention in hemodialysis patients who were divided into two groups (high-nutrition and low-nutrition groups) based on the serum albumin levels. Method: A total of 26 outpatients (18 men and 8 women) undergoing hemodialysis (age: 66 ± 10 years) were included in this study. The patients'' body composition data (weight, body mass index, percentage of body fat, fat-free mass, and total body water) and physical functions (grip strength, knee extensor strength, open-eyed one-legged standing time, long sitting trunk anteflexion, and 6-minute walking distance [6MWD] test) were measured. The intervention was supine ergometer exercise during hemodialysis, and the patients exercised for 30 minutes during hemodialysis thrice a week. The intervention period was three months. Results: Compared to the high-nutrition group, the low-nutrition group showed a significant decrease in muscle strength. Furthermore, long sitting trunk anteflexion in the high-nutrition group and 6MWD in the low-nutrition group improved significantly after the intervention. Conclusion: The result of this study may indicate that 6MD can be improved by exercise during dialysis, regardless of nutritional status. It is said that low nutritional status has a negative impact on survival rate; thus, considering the impact on survival rate, it is hemodialysis patients with a low nutritional status that should be considered to introduce more active exercise during dialysis.     

Joint Angle Variability Is Altered in Patients with Peripheral Artery Disease after Six Months of Exercise Intervention

Supervised exercise therapy (SET) is a conservative non-operative treatment strategy for improving walking performance in patients with peripheral artery disease (PAD). Gait variability is altered in patients with PAD, but the effect of SET on gait variability is unknown. Forty-three claudicating patients with PAD underwent gait analysis before and immediately after a 6-month SET program. Nonlinear gait variability was assessed using sample entropy, and the largest Lyapunov exponent of the ankle, knee, and hip joint angle time series. Linear mean and variability of the range of motion time series for these three joint angles were also calculated. Two-factor repeated measure analysis of variance determined the effect of the intervention and joint location on linear and nonlinear dependent variables. After SET, walking regularity decreased, while the stability remained unaffected. Ankle nonlinear variability had increased values compared with the knee and hip joints. Linear measures did not change following SET, except for knee angle, in which the magnitude of variations increased after the intervention. A six-month SET program produced changes in gait variability toward the direction of healthy controls, which indicates that in general, SET improved walking performance in individuals with PAD.     

Evidence of Improvement in Various Impairments by Exercise Interventions in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Clinical Trials

Purpose: To investigate improvement in various impairments by exercise interventions in patients with knee osteoarthritis (OA). Methods: We collected data on randomized controlled trials (RCTs) comparing the effects of exercise intervention with those of either nonintervention or psychoeducational intervention in patients with knee OA. Data on pain, stiffness, muscle strength, range of motion, flexibility, maximal oxygen uptake, and position sense were synthesized. The Grading of Recommendations Assessment, Development, and Evaluation system was used to determine the quality of the evidence. Results: Thirty-three RCTs involving 3,192 participants were identified. Meta-analysis provided highquality evidence that exercise intervention improves maximal oxygen uptake, and moderate-quality evidence that exercise intervention also improves pain, stiffness, knee extensor and flexor muscle strength, and position sense. The evidence that exercise intervention improves knee extension and flexion range of motion was deemed as undetermined-quality. Conclusion: In patients with knee OA, improvement in pain, stiffness, muscle strength, maximal oxygen uptake, and position sense with the use of exercise intervention can be expected. Although the quality of evidence of the effect of exercise intervention on range of motion was inconclusive, exercise intervention should be recommended for patients with knee OA to improve various impairments.     

Relationship between Muscle Flexibility and Characteristics of Muscle Contraction in Healthy Women during Different Menstrual Phases

Objective: Skeletal muscle function is vital for preventing injury during exercise. It has been reported that skeletal muscle function fluctuates with the menstrual cycle and is considered one of the causes of injury. This study aimed to clarify the relationship between muscle flexibility and muscle contraction characteristics and their changes with the menstrual cycle. Methods: The subjects were healthy women who voluntarily participated in the study through recruitment posters. Muscle flexibility was measured with the passive knee extension (PKE) test, isokinetic knee flexor strength, and the maximum muscle strength exertion angle under two conditions of 60°/s and 120°/s in dominant hamstrings. Additionally, their correlations were analyzed and compared between the menstrual and ovulatory phases. Results: Sixteen subjects (mean age: 20.56 ± 0.73 years; body mass index: 20.21 ± 1.60) participated in the study. Correlation analysis showed a significant negative correlation between PKE and the maximum muscle strength exertion angle under the condition of 60°/s during the menstrual phase (r = –0.54; p = 0.03). No significant difference was observed in the two-group comparison of the variables measured during the menstrual and ovulatory phases. Conclusion: This study confirmed that the more flexible muscles generate the maximum strength at a more contracted position during the menstrual phase in women. In the future, it is necessary to examine the relationship between the results of this study and exercise performance and injury occurrence.     

Histological and histochemical effects after occlusion alteration in suprahyoid muscles

This study verified the effect of unilateral teeth extraction on the suprahyoid muscles in gerbils (Meriones unguiculatus). Ten adult male gerbils weighing about 50g had induced occlusal alterations by upper molar teeth extraction on the left side while the other ten animals were only subjected to surgical stress, control group. After 60 days, animals of both groups, experimental and control had the suprahyoid muscles removed and processed for histological and histochemical (adenosine triphosphatase (ATPase), nicotine adenine dinucleotide tetrazolium reductase (NADH-TR) and succinate dehydrogenase (SDH)) purposes. The fiber type area was estimated in % according to Weibel method (point-counting method) using a test-system. The myosinic ATPase pH 4.7 activity in the control group of the digastric, milohyoid and geniohyoid muscles presented a small area of type I fiber and a larger area of type IIa fibers; in the experimental group, significant contractile capacity alteration was not observed. Samples of the digastric, milohyoid and geniohyoid muscles, after SDH activity, showed a small area with high metabolic activity fibers, and a large area with intermediary and low metabolic activity fibers in the control group. The milohyoid muscle of the experimental group presented low metabolic fibers in a reduced area, in both sides, however without significant difference. In the experimental group, high metabolic fibers were observed on the left side in a reduced area in the geniohyoid muscle, but without statistical significance. Thus, the geniohyoid muscle did not change the metabolic activity after occlusal alteration. In conclusion, 60 days of unilateral malocclusion induced was able to alter the fibers oxidative activity of the suprahyoid muscles, however, it does not affect the contractile property of the fibers. The digastric muscle has adequate fibers to produce fast contraction and able to resist to fatigue in intermediate degrees, but became more fatigable after unilateral exodontia.     

儿童发育性髋关节脱位的磁共振形态学定量

发育性髋关节脱位（developmental dysplasia of the hip,DDH）作为一类常见的、严重威胁儿童健康成长的髋关节疾病会严重影响到儿童的肢体发育和生活质量,其早诊断、早治疗非常重要.磁共振成像（magnetic resonance imaging,MRI）技术可提供丰富的有关髋关节发育情况的形态学信息.目前,基于磁共振图像的DDH临床诊断主要凭借医生的肉眼观测,对医生要求甚高,而且无法定量判断DDH病情.本文提出了一种针对儿童DDH磁共振图像的形态学定量评估方法,通过对DDH病理改变密切相关的形态学参数的自动测定,完成形态学参数的定量评估,为临床提供辅助的量化参考.该方法包括磁共振图像预处理、股骨及盆骨分割、髋关节三维模型重建,以及结合了厚度搜索、三维霍夫变换和最小二乘拟合等算法实现的中心边缘角（center-edge angle,CEA）、髋臼角（acetabular index,AI）和股骨颈前倾角（femoral neck anteversion,FNA）等重要指标的自动测量.儿童DDH形态学定量评估方法的建立对儿童DDH的筛查、诊断和确诊患儿手术方案的制定,以及术后的动态随访,都具有重要参考价值.     

Joint Function and Arthropathy Severity in Patients with Hemophilia

Background: The Arnold-Hilgartner classification is one of the most popular evaluation systems for the progression hemophilic arthropathy. A previous study reported an association between arthropathy severity and arc range of motion (ROM). However, associations between arthropathy severity and angular ROM and muscle strength remain unclear. AIM: The purpose of this study was to clarify the association between joint function and arthropathy severity in hemophilia. Methods: We studied the knee, ankle, and elbow joints of 31 patients with hemophilia (PWH). The condition of the affected joints was evaluated on the basis of the interview data, joint function measurements, and roentgenography of the affected joints. In assessment of joint function, we evaluated knee strength (flexor, extensor) and grip strength as well as the passive ROM of the elbow, knee, and ankle. During the interview, all patients were asked about the history of intra-articular bleeding over the past year and pain. Results: As arthropathy severity worsened, knee flexor strength, knee extensor strength, grip strength, and ROM (elbow flexion, elbow extension, knee flexion, knee extension, and ankle extension) significantly decreased. Even patients with mild arthropathies experienced knee extensor weakness and extension limitation. In addition, joint function of severe ankle arthropathy was significantly related to the history of intra-articular bleeding and pain. Conclusion: Our results suggest that physical therapy is necessary to improve joint function in PWH and mild or no arthropathy. Pain control and prophylactic hematological management are necessary for patients with severe arthropathy because intra-articular bleeding and pain significantly decrease joint function.     

Interfacial adhesion between semi-crystalline polymers (polypropylene and nylon-6): in situ compatibilized interface and fracture mechanism

The interfacial fracture toughness between semi-crystalline polymers (polyamide/polypropylene) were studied to understand the failure mechanisms at the interface, especially when the interface was reinforced by an in situ compatibilizer. Based on the observation of the interface using scanning electron microscopy and wide angle X-ray spectroscopy, it was revealed that crystalline structure of polypropylene was not affected by the in situ compatibilizer at the interface. The reinforcing mechanism could be qualitatively identified by investigating the evolution of fracture toughness as a function of annealing time and temperature. The adhesion strength increased with the annealing time. Depending on the annealing temperature, the fracture toughness passed a peak value and then reached a plateau after some bonding time. As long as the chain length of the compatibilizer is long enough to form entanglements with the molecules at both bulk sides, the fracture at the interface is decided by the balance between adhesion strength at the interface and cohesive strength in the weak modulus side; the failure locus follows the lower one. Thus, adhesive failure occurred first when the reaction at the interface did not occur long enough to provide high adhesive strength at the interface, but the cohesive failure occurred in the crack propagation side after the adhesive strength value became higher than the cohesive strength value.     

Potential distribution in ferroelectric ceramic during pulsed exoelectron emission

The potential and polarization distributions in a planar emitting layer of PLZT-9/65/35 ferroelectric ceramic with a set of conductive strip electrodes on the emitting side and a continuous electrode on the opposite side are studied by numerical methods. The state arising immediately after polarization switching at the leading edge of an applied voltage pulse (i.e., before the polarization charges are screened by free charges) is considered. When the pulsed field strength far exceeds the double coercive field, regions with alternating polarization are found to form in the surface layer between the strips. The normal component of the polarization at its maxima is close to saturation. The electric field on both sides of the surface varies as the polarization vector and reaches 200 kV/cm. At surface microirregularities, the electric field strength is much higher. This means that field emission is responsible for electron escape from the ferroelectric ceramic during pulsed polarization switching.     

轻中度单侧Bell面瘫红外热辐射强度异常分析

Bell 面瘫是一种多发的面神经疾病,首次发病以轻中度居多.应用红外热成像原理,探寻一种客观无创的Bell面瘫评估方法.人体面部穴位大都呈左右对称分布,取患者病变一侧的相关穴位为实验组,另一侧同一穴位为对照组,分别研究其红外热辐射特性,急性期内,同一穴位在健侧与患侧的红外热辐射强度差异显著,即存在明显的温差(大于0.3...     

Importance of knee flexion range of motion during the acute phase after total knee arthroplasty

Background: We investigate the association with knee flexion range of motion (ROM) during the acute phases and that at 12 months after total knee arthroplasty (TKA). We also clarified the cut-off ROM during the acute phases in predicting the goal of knee flexion ROM at 12 months. Methods: In this retrospective study, 193 patients with knee osteoarthritis (female:144 patients, age:73.2 ± 7.7 years) who underwent unilateral TKA at an orthopedic clinic were recruited. They underwent assessments of knee flexion ROM at 5 days, 1 month, and 12 months after TKA. The goal of knee flexion ROM at 12 months after TKA was set at 120°. Single and logistic-regression analyses were performed with the dependent variables including the outcome of the goal of knee flexion ROM at 12 months, and the independent variables included knee flexion ROM at 5 days and 1 month, separately. We calculated the cut-off ROM at 5 days and 1 month for predicting the goal of knee flexion ROM at 12 months with receiver operating curve analysis. Results: Knee flexion ROM at 5 days and 1 month were significantly associated with the goal of that at 12 months (p < 0.01). The cut-off ROM were 85° at 5 days and 105° at 1 month separately. Conclusions: Our results suggest the importance of early improvement in knee flexion ROM after TKA, and that at 1 month postoperatively indicates the likelihood of achievement of the goal of knee flexion ROM at 12 months after TKA.