Design comparison: manipulation after total knee arthroplasty

Postoperative stiffness is a relatively uncommon issue in total knee arthroplasty (TKA). However, it can be a debilitating complication when it occurs. Manipulation under anesthesia (MUA) is commonly used as the primary treatment modality following failed physiotherapy. The Advance medial pivot knee (Wright Medical Technology) was created in an effort to prevent stiffness postoperatively and increase range of motion. The Evolution medial pivot knee is a second-generation design that builds on the technology of the Advance knee. This article presents a retrospective review of prospectively collected data on 881 primary medial pivot knees (592 Advance knees, 289 Evolution knees). It was theorized that the design changes made to the Evolution knees might contribute toward reducing the need for MUA. It was found that the Evolution knees required significantly fewer manipulations under anesthesia (p = .036). The design modifications made to the Evolution knees may have contributed to the lower rate of MUA.