The stiff total knee arthroplasty: Evaluation and management☆,☆☆
Section snippets
Preoperative evaluation
One of the most important factors in evaluating a patient with a stiff knee after TKA is understanding where the patient started in terms of range of motion before surgery. Multiple studies have documented that preoperative flexion is the most important variable in determining the patient's postoperative flexion 2, 3, 4, 5, 6. It is important for the operating surgeon to record the patient's preoperative flexion. There is a paradox as it relates to range of motion preoperatively and
Management
When the cause of the postoperative stiffness has been determined, one can focus on management. When a patient develops a stiff knee >6 to 8 weeks after surgery, it is unusual for range to improve significantly with physical therapy, continuous passive motion, or other modalities. For the patient who has arthrofibrosis, manipulation under anesthesia is a good option. Arthrofibrosis is defined as periarticular fibrosis that limits range of motion by forming bands of scar tissue between the
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Cited by (0)
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No benefits or funds were received in support of this study.
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Reprint requests: William J. Maloney, MD, Department of Orthopaedic Surgery, Washington University School of Medicine, 660 South Euclid, Campus Box 8233, St. Louis, MO 63110. E-mail: [email protected]