The stiff total knee arthroplasty: causes and cures

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Musculoskeletal Disorders

Background:

• Stiffness following total knee arthroplasty (TKA) is a significant complication.
• Identifying the underlying causes of TKA stiffness is crucial for effective treatment.
• Previous research has explored various etiologies, but a comprehensive approach is often needed.

Observation:

• This study presents seven cases of stiff total knee arthroplasty.
• The cases highlight diverse etiologies contributing to stiffness, including manipulation under general anesthesia, concurrent diagnoses, extra-articular pathology, and pain.
• Component internal rotation and multifactorial causes were also identified as significant contributors.

Findings:

• Stiffness in total knee arthroplasty is often multifactorial, involving a triad of pain, limited flexion, and limited extension.
• Extra-articular pathology and component malrotation (internal rotation) are critical considerations.
• The role of surgical exposure in managing these complex cases is emphasized.

Implications:

• Understanding the multifactorial nature of stiffness is crucial for accurate diagnosis and effective treatment planning in total knee arthroplasty.
• Early identification and management of contributing factors like pain and component alignment can improve functional outcomes.
• Further research into optimizing surgical techniques and patient selection may reduce the incidence of stiffness after total knee arthroplasty.