The stiff total knee arthroplasty: causality and solution.

A stiff total knee arthroplasty is a disabling condition, which can be caused by technical errors, patient factors, and postoperative complications. The results of treatment are dependent on the cause of stiffness. The best treatment is prevention by providing preoperative patient education, aggressive postoperative rehabilitation, and avoidance of technical errors. Early manipulation may improve motion with a well-aligned component. Open arthrolysis and revision arthroplasty are indicated for chronic stiffness with component malposition or failure, incorrect component sizing, joint line displacement, or inadequate bone resection. When performing a revision arthroplasty, it is important to know the reason for failure and loss of motion because failure to identify the cause of stiffness may result in recurrence of the problem.