How often is functional range of motion obtained by manipulation for stiff total knee arthroplasty?

Int Orthop. 2014 Aug;38(8):1641-5. doi: 10.1007/s00264-014-2421-z. Epub 2014 Jul 4.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / surgery
  • Arthroplasty, Replacement, Knee / methods*
  • Female
  • Humans
  • Knee Joint / physiology*
  • Knee Joint / surgery
  • Logistic Models
  • Male
  • Manipulation, Orthopedic / methods*
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Osteonecrosis / surgery
  • Range of Motion, Articular / physiology*
  • Recovery of Function / physiology
  • Retrospective Studies
  • Treatment Outcome