title: Repeat Manipulation Under Anesthesia For Persistent Stiffness After Total Knee Arthroplasty Achieves Functional Range of Motion.
abstract: Poor range of motion may decrease a patient's ability to participate in activities of daily living after total knee arthroplasty. Manipulation under anesthesia has been shown to improve range of motion; however, some patients have persistent stiffness even after manipulation. The goal of this study was to evaluate the outcomes and complications of patients who underwent a second manipulation under anesthesia for persistent stiffness after total knee arthroplasty. The review of surgical records of two joint arthroplasty surgeons identified 226 knees in 210 patients who underwent a manipulation under anesthesia for poor range of motion after total knee arthroplasty. Of these patients, 16 patients underwent a second manipulation under anesthesia. For patients undergoing two manipulations under anesthesia procedures, at latest follow up (mean 539 days), mean extension improved from 10.50° to 2.50° (p=0.001) and mean flexion improved from 87.50° to 112.69° (p=0.001) respectively. SF-12 scores were available for 12 of 16 knees with a mean score of 34.42. Two of 16 patients (12.5%) experienced a complication. Three of 16 (18.8%) patients who underwent a second manipulation required a revision arthroplasty procedure. In conclusion, a second manipulation under anesthesia can achieve functional range of motion that is sustained after total knee arthroplasty.
authors.affiliation: Department of Orthopedic Surgery, Mount Carmel Health System, Columbus, Ohio.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Ferrel
authors.affiliation: Department of Orthopedic Surgery, Mount Carmel Health System, Columbus, Ohio.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Davis
authors.affiliation: Department of Orthopedic Surgery, The Cardinal Orthopedic Institute / Orthopedic One, Columbus, Ohio.
authors.forename: Obiajulu A J C
authors.initials: OA
authors.lastname: Agha
authors.affiliation: Department of Orthopedic Surgery, Mount Carmel Health System, The Cardinal Orthopaedic Institute / Orthopedic One, Columbus, Ohio.
authors.forename: Joel R
authors.initials: JR
authors.lastname: Politi
mesh_terms: D000368:Aged; D000758:Anesthesia; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods* / Q000706:statistics & numerical data*; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome