Abstract
Purpose
To evaluate how often manipulation under anesthesia (MUA) can achieve functional flexion ≥ 90 degrees and identify predictor for successful outcome of MUA for stiff total knee arthroplasty (TKA).
Methods
Demographic data, range of motion, and surgical and anesthetic information of 143 MUAs were retrospectively analyzed from 2000 to 2011.
Results
One-hundred thirty-six out of 143 patients (95 %) improved mean range of motion (ROM) from pre-MUA 62 ± 17° to final ROM 101 ± 21° (p < 0.001). Flexion ≥ 90 degrees was achieved in 74% (106/143) of patients. Regional anesthesia was identified as predictor of successful MUA outcome (p = 0.007, OR: 8.5, 95 % CI: 1.2-66.7).
Conclusions
Although the proportion of patients regaining flexion ≥ 90 degrees following MUA was less than those patients with simple overall ROM increase, the functional flexion ≥ 90 degrees was achieved in the vast majority of patients with stiff TKA following MUA.
Similar content being viewed by others
References
Debette C, Lustig S, Servien E, Lording T, Villa V, Demey G, Neyret P (2014) Total knee arthroplasty of the stiff knee: three hundred and four cases. Int Orthop 38:285–289
Anania A, Abdel MP, Lee YY, Lyman S, Gonzalez Della Valle A (2013) The natural history of a newly developed flexion contracture following primary total knee arthroplasty. Int Orthop 37:1917–1923
Fox JL, Poss R (1981) The role of manipulation following total knee replacement. J Bone Joint Surg Am 63:357–362
Keating EM, Ritter MA, Harty LD, Haas G, Meding JB, Faris PM, Berend ME (2007) Manipulation after total knee arthroplasty. J Bone Joint Surg Am 89:282–286
Gonzalez Della Valle A, Leali A, Haas S (2007) Etiology and surgical interventions for stiff total knee replacements. Hss J 3:182–189
Lutzner J, Kirschner S, Gunther KP, Harman MK (2012) Patients with no functional improvement after total knee arthroplasty show different kinematics. Int Orthop 36:1841–1847
Laubenthal KN, Smidt GL, Kettelkamp DB (1972) A quantitative analysis of knee motion during activities of daily living. Phys Ther 52:34–43
Bawa HS, Wera GD, Kraay MJ, Marcus RE, Goldberg VM (2013) Predictors of Range of Motion in Patients Undergoing Manipulation After TKA. Clin Orthop Relat Res 471:258–263
Cates HE, Schmidt JM (2009) Closed manipulation after total knee arthroplasty: outcome and affecting variables. Orthopedics 32:398
Ellis TJ, Beshires E, Brindley GW, Adams RL, Preece C (1999) Knee manipulation after total knee arthroplasty. J South Orthop Assoc 8:73–79
Mohammed R, Syed S, Ahmed N (2009) Manipulation under anaesthesia for stiffness following knee arthroplasty. Ann R Coll Surg Engl 91:220–223
Fitzsimmons SE, Vazquez EA, Bronson MJ (2010) How to treat the stiff total knee arthroplasty?: a systematic review. Clin Orthop Relat Res 468:1096–1106
Esler CN, Lock K, Harper WM, Gregg PJ (1999) Manipulation of total knee replacements. Is the flexion gained retained? J Bone Joint Surg Br 81:27–29
Namba RS, Inacio M (2007) Early and late manipulation improve flexion after total knee arthroplasty. J Arthroplasty 22:58–61
Maloney WJ (2002) The stiff total knee arthroplasty: evaluation and management. J Arthroplasty 17:71–73
Mulholland SJ, Wyss UP (2001) Activities of daily living in non-Western cultures: range of motion requirements for hip and knee joint implants. Int J Rehabil Res 24:191–198
Scranton PE Jr (2001) Management of knee pain and stiffness after total knee arthroplasty. J Arthroplasty 16:428–435
Yercan HS, Sugun TS, Bussiere C, Ait Si Selmi T, Davies A, Neyret P (2006) Stiffness after total knee arthroplasty: prevalence, management and outcomes. Knee 13:111–117
Ipach I, Mittag F, Lahrmann J, Kunze B, Kluba T (2011) Arthrofibrosis after TKA - Influence factors on the absolute flexion and gain in flexion after manipulation under anaesthesia. BMC Musculoskelet Disord 12:184
Ghani H, Maffulli N, Khanduja V (2012) Management of stiffness following total knee arthroplasty: A systematic review. Knee 19:751–759
Rubinstein RA Jr, DeHaan A (2010) The incidence and results of manipulation after primary total knee arthroplasty. Knee 17:29–32
Yeoh D, Nicolaou N, Goddard R, Willmott H, Miles K, East D, Hinves B, Shepperd J, Butler-Manuel A (2012) Manipulation under anaesthesia post total knee replacement: long term follow up. Knee 19:329–331
Pariente GM, Lombardi AV Jr, Berend KR, Mallory TH, Adams JB (2006) Manipulation with prolonged epidural analgesia for treatment of TKA complicated by arthrofibrosis. Surg Technol Int 15:221–224
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Choi, HR., Siliski, J., Malchau, H. et al. How often is functional range of motion obtained by manipulation for stiff total knee arthroplasty?. International Orthopaedics (SICOT) 38, 1641–1645 (2014). https://doi.org/10.1007/s00264-014-2421-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-014-2421-z