Knee manipulation after total knee arthroplasty

To determine if any factors are associated with knee stiffness after total knee arthroplasty (TKA), we retrospectively reviewed the medical records and radiographs of patients who had knee manipulation after total knee replacement at Scott & White Memorial Hospital from 1983 to 1993. Twenty-five patients who had knee manipulation after TKA were matched by surgeon, year of surgery, and age (+/- 5 years) with a study group of 25 patients who did not have knee manipulation after TKA. Patients in the manipulated group had decreased flexion at the time of discharge from the hospital after the knee arthroplasty and a decreased final flexion. The age of the patient, time from surgery to manipulation, and preoperative flexion did not correlate with final flexion attained in the manipulated group. Relative to the control study group, the manipulated group had an increase in postoperative anteroposterior femoral thickness. A decrease in patellar height was noted both in the manipulated group and in the control nonmanipulated group. There was no significant difference between groups for a change in patellar height.