The incidence and results of manipulation after primary total knee arthroplasty.
This study investigates a cohort of patients who required a manipulation after total knee arthroplasty (TKA) to determine whether there was an association between pre-TKA and post-manipulation range of motion (ROM). Thirty-seven of 800 TKAs were manipulated (4.6% incidence); complete data were available for 36 knees. The pre-TKA stiff group (<110 degrees total arc of motion; n=16), on average, had 27 degrees less arc of motion before TKA than the non-stiff group (n=20; p<0.001). Mean arc of motion in the stiff group was 68 degrees before manipulation and 109 degrees after manipulation (p<0.001). Mean arc of motion in the non-stiff group was 80 degrees before manipulation and 118 degrees after manipulation (p<0.001). Patients with pre-TKA stiffness improved from a total arc of motion of 94 to 109 (p<0.001) while patients without pre-TKA stiffness changed from 121 to 118 (p=0.169). In both groups, the success of TKA can still be high despite early motion loss and subsequent manipulation.
Rubinstein
Richard A
RA
Portland Knee Clinic, Portland, OR, United States. rrubinjr@comcast.net
DeHaan
Alex
A
D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015331:Cohort Studies; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000601:surgery*; D026741:Physical Therapy Modalities; D011183:Postoperative Complications / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone