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Manipulation after total knee arthroplasty.

E Michael Keating¹, Merrill A Ritter, Leesa D Harty

¹Center for Hip and Knee Surgery, St. Francis Hospital, 1199 Hadley Road, Mooresville, IN 46158, USA.

The Journal of Bone and Joint Surgery. American Volume

|February 3, 2007

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Manipulation after total knee arthroplasty significantly improves knee flexion for most patients. Severe preoperative pain indicates a higher likelihood of needing this procedure for better outcomes.

Area of Science:

Orthopedic Surgery
Rehabilitation Medicine
Biomechanical Engineering

Background:

Limited knee flexion after total knee arthroplasty (TKA) may necessitate manipulation under anesthesia.
Assessing outcomes of manipulation is crucial for patient recovery post-TKA.

Purpose of the Study:

To evaluate the effectiveness of manipulation for improving knee flexion after TKA.
To identify factors influencing the need for manipulation and its success.

Main Methods:

113 knees in 90 patients underwent manipulation for flexion ≤90 degrees at a mean of 10 weeks post-TKA.
Knee flexion was measured pre-TKA, post-op, pre-manipulation, post-manipulation, and at 6 months, 1, 3, and 5 years.

Main Results:

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90% of patients achieved improved knee flexion post-manipulation.
Average flexion improvement from pre-manipulation to 5-year follow-up was 35 degrees (p < 0.0001).
Patients requiring manipulation had significantly higher preoperative pain scores.

Conclusions:

Manipulation is generally effective in increasing ultimate knee flexion after TKA.
Severe preoperative pain is a predictor for requiring manipulation post-TKA.