Manipulation under Anesthesia for Stiffness after Total Knee Arthroplasty

• Published in: Knee Surgery and Related Research, 27(4) Vol. 27; no. 4; pp. 233 - 239
• Main Authors: Yoo, Ju-Hyung, Oh, Jin-Cheol, Oh, Hyun-Cheol, Park, Sang-Hoon
• Format: Journal Article
• Language: English
• Published: England The Korean Knee Society 01-12-2015; 대한슬관절학회
• Subjects: Original; 정형외과학; Knee; Arthroplasty; Stiffness; Manipulation
• ISSN: 2234-0726; 1225-1623; 2234-2451
• DOI: 10.5792/ksrr.2015.27.4.233

This study evaluated the incidence of manipulation under anesthesia (MUA) for stiffness after total knee arthroplasty (TKA) and the degree of joint motion recovery after MUA.
A total of 4,449 TKAs (2,973 patients) were performed between March 2000 and August 2014. Cases that underwent MUA for stiffness after TKA were reviewed. TKAs were performed using the conventional procedure in 329 cases and using the minimally invasive procedure in 4,120 cases. The preoperative range of joint motion, timing of manipulation, diagnosis and the range of joint motion before and after MUA were retrospectively investigated.
MUA was carried out in 22 cases (16 patients), resulting in the incidence of 0.5%. The incidence after the conventional procedure was 1.2% and 0.4% after the minimally invasive procedure. In the manipulated knees, the preoperative range of motion (ROM) was 102.5°±26.7°, and the preoperative diagnosis was osteoarthritis in 19 cases, rheumatoid arthritis in two, and infection sequela in one. MUA was performed 4.7±3.0 weeks after TKA. The average ROM was 64.5°±13.5° before manipulation. At an average of 64.3±41.3 months after manipulation, the ROM was recovered to 113.4°±31.2°, which was an additional 49.9° improvement in flexion.
The satisfactory recovery of joint movement was achieved when MUA for stiffness was performed relatively early after TKA.