BACKGROUND: Knee stiffness or limited range of motion (ROM) after total knee arthroplasty (TKA) may compromise patient function. Patients with stiffness are usually managed with manipulation under anesthesia (MUA) to improve ROM. However, the final ROM obtained is multifactorial and may depend on factors such as comorbidities, implant type, or the timing of MUA. QUESTIONS/PURPOSES: We asked whether diabetes mellitus, implant type, and the interval between TKA and MUA influenced post-MUA ROM. METHODS: From a group of 2462 patients with 3224 TKAs performed between 1999 and 2007 we retrospectively reviewed 96 patients with 119 TKAs (4.3%) who underwent MUA. We determined the presence of diabetes mellitus, implant type, and the interval between TKA and MUA. RESULTS: The average increase in ROM after MUA was 34°. Patients with diabetes mellitus experienced lower final ROM after MUA (87.5° versus 100.3°) as did patients with cruciate-retaining (CR) prostheses versus posterior-stabilized (92.3° versus 101.6°). The interval between TKA and MUA inversely correlated with final ROM with a decrease after 75 days. CONCLUSIONS: Most patients experience improvements in ROM after MUA. Patients with diabetes mellitus or CR prostheses are at risk for lower final ROM after MUA. Manipulation within 75 days of TKA is associated with better ROM.
BACKGROUND:Knee stiffness or limited range of motion (ROM) after total knee arthroplasty (TKA) may compromise patient function. Patients with stiffness are usually managed with manipulation under anesthesia (MUA) to improve ROM. However, the final ROM obtained is multifactorial and may depend on factors such as comorbidities, implant type, or the timing of MUA. QUESTIONS/PURPOSES: We asked whether diabetes mellitus, implant type, and the interval between TKA and MUA influenced post-MUA ROM. METHODS: From a group of 2462 patients with 3224 TKAs performed between 1999 and 2007 we retrospectively reviewed 96 patients with 119 TKAs (4.3%) who underwent MUA. We determined the presence of diabetes mellitus, implant type, and the interval between TKA and MUA. RESULTS: The average increase in ROM after MUA was 34°. Patients with diabetes mellitus experienced lower final ROM after MUA (87.5° versus 100.3°) as did patients with cruciate-retaining (CR) prostheses versus posterior-stabilized (92.3° versus 101.6°). The interval between TKA and MUA inversely correlated with final ROM with a decrease after 75 days. CONCLUSIONS: Most patients experience improvements in ROM after MUA. Patients with diabetes mellitus or CR prostheses are at risk for lower final ROM after MUA. Manipulation within 75 days of TKA is associated with better ROM.
Authors: L Brosseau; S Balmer; M Tousignant; J P O'Sullivan; C Goudreault; M Goudreault; S Gringras Journal: Arch Phys Med Rehabil Date: 2001-03 Impact factor: 3.966
Authors: Ho-Rim Choi; John Siliski; Henrik Malchau; Andrew Freiberg; Harry Rubash; Young-Min Kwon Journal: Int Orthop Date: 2014-07-04 Impact factor: 3.075
Authors: Alex Gu; Adam J Michalak; Jordan S Cohen; Jeffrey G Stepan; Neil D Almeida; Alexander S McLawhorn; Peter K Sculco Journal: J Orthop Date: 2018-08-16