title: Clinical, objective, and functional outcomes of manipulation under anesthesia to treat knee stiffness following total knee arthroplasty.
abstract: The purpose of this study was to determine the clinical outcomes of manipulation under anesthesia (MUA) in a cohort who had developed knee stiffness following total knee arthroplasty (TKA). One-hundred and forty-five TKAs in 134 patients who had undergone MUA were compared to the remaining 1973 TKAs in 1671 patients who did not develop this condition. At a mean follow-up of 51 months (range, 24 to 85 months), the mean gains in flexion in the MUA cohort were 33° (range, 5° to 65°). The final range-of-motion in the MUA cohort was lower than the comparison cohort (114° versus 125°) however, this would meet the required flexion for activities of daily living. There were no differences in the Knee Society objective and functional scores between the two cohorts. It is encouraging that MUA cohort outcomes were comparable to outcomes of patients who did not develop knee stiffness.
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Bhaveen H
authors.initials: BH
authors.lastname: Kapadia
authors.affiliation: Stryker Orthopaedics, Inc., Mahwah, New Jersey.
authors.forename: Mark
authors.initials: M
authors.lastname: Kester
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Harpal S
authors.initials: HS
authors.lastname: Khanuja
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Delanois
authors.affiliation: Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery*; D008297:Male; D008349:Manipulation, Orthopedic; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome
keywords: arthrofibrosis; flexion; knee stiffness; manipulation under anesthesia; range-of-motion; total knee arthroplasty