title: Manipulation Under Anesthesia After Total Knee Arthroplasty is Associated with An Increased Incidence of Subsequent Revision Surgery.
abstract: A national database was used to evaluate the risk for manipulation under anesthesia (MUA) after total knee arthroplasty (TKA), the association of demographics and comorbidities with needing MUA, and the risk of revision TKA after MUA. Of the 141,016 patients who underwent TKA, 4.3% required MUA within 6 months. Age under 50 years (OR: 2.79, P<0.0001), age 50-65 years (OR: 2.03, P<0.0001), and female gender (OR: 1.12, P<0.0001) were all associated with increased rates of MUA. In patients under age 65 years, smoking (OR: 1.47, P<0.0001) was associated with an increased rate of MUA. Patients who require MUA within 6 months after TKA have a significantly increased risk of early revision TKA (OR: 2.43, P<0.0001).
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: James B
authors.initials: JB
authors.lastname: Carr
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: John C
authors.initials: JC
authors.lastname: Wiggins
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: F Winston
authors.initials: FW
authors.lastname: Gwathmey
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia.
authors.forename: James A
authors.initials: JA
authors.lastname: Browne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D015994:Incidence; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000009:adverse effects* / Q000706:statistics & numerical data*; D016059:Range of Motion, Articular; D012086:Reoperation / Q000706:statistics & numerical data*; D012907:Smoking; D014481:United States
keywords: arthrofibrosis; manipulation under anesthesia; revision; risk factors; total knee arthroplasty