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Early and late manipulation improve flexion after total knee arthroplasty
1Department of Orthopedic Surgery, Kaiser Permanente, Orange County, Anaheim, California 92807, USA.
The Journal of Arthroplasty
|October 11, 2007
Summary
Manipulation under anesthesia (MUA) effectively improves pain and flexion after total knee arthroplasty (TKA), regardless of whether it is performed early or late post-surgery. Patient satisfaction, however, did not show significant improvement.
Area of Science:
- Orthopedic Surgery
- Rehabilitation Medicine
Background:
- Total knee arthroplasty (TKA) is a common procedure for end-stage knee osteoarthritis.
- Limited range of motion and stiffness are common postoperative complications following TKA.
- Manipulation under anesthesia (MUA) is a procedure to regain knee flexion and reduce pain.
Purpose of the Study:
- To evaluate the effectiveness of early (<90 days) versus late (>90 days) manipulation under anesthesia (MUA) after total knee arthroplasty (TKA).
- To compare improvements in pain, satisfaction, flexion, and extension between early and late MUA groups.
Main Methods:
- Retrospective review of a total joint registry of 9640 primary TKAs.
- Identified 195 patients who underwent MUA, with 102 in the early group and 93 in the late group.
- Assessed pain, satisfaction, flexion, and extension before and after MUA using a 10-point scale and degree measurements.
Main Results:
- Both early and late MUA significantly improved knee flexion (P < .001 and P = .001, respectively).
- Pain significantly decreased in both groups (P = .048).
- Extension improved significantly only in the early MUA group; patient satisfaction scores did not improve.
Conclusions:
- Manipulation under anesthesia is effective in improving pain and flexion after TKA, even when performed later than 90 days postoperatively.
- Early MUA may offer additional benefits for improving knee extension.
- Further research may explore factors influencing patient satisfaction after MUA.
