Stiffness After Total Knee Replacement
DOI:
https://doi.org/10.25759/spmfr.200Keywords:
Arthroplasty, Replacement, Knee/adverse effects, Range of Motion, ArticularAbstract
The goals of total knee arthroplasty are to minimize knee pain, promote articular stability during gait and maximize the range of motion. The prevalence of knee stiffness after arthroplasty can reach 25%. The scientific community points out, as main risk factors for its appearance, a smaller preoperative range of motion, the lack of collaboration of the patient in a rehabilitation program, patella ínfera and the use of coumarinic anticoagulation. The improvement of knee range of motion rarely occurs after six months of arthroplasty, even under an appropriate rehabilitation program. In case of postoperative stiffness, the most effective option for current gain of range includes joint manipulation under anesthesia. Arthroscopic or open arthrolysis has modest results in the gain of range of motion as well as revision arthroplasty. However, the latter proves to be effective in individual cases of stiffness with flexion contracture.
Downloads
References
Artz N, Elvers KT, Sackley C, Jepson P, Beswick AD. Effectiveness of physiotherapy exercise following total knee replacement:
systematic review and meta-analysis. BMC Musculoskelet Disord. 2015; 16:15.
Minns Lowe C, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after total knee arthroplasty for
osteoarthritis: systematic review and meta-analysis of randomized controlled trials. BMJ. 2007; 1-9.
Bonutti PM, Marulanda GA, McGrath MS, Mont MA, Zywiel MG. Static progressive stretch improves range of motion in
arthrofibrosis following total knee arthroplasty. Knee Surg Sports Traumat Arthrosc. 2010; 18:194-99.
Issa K, Kapadia BH, Kester M, Khanuja HS, Delanois RE, Mont MA. Clinical, objective and functional outcomes of manipulation
under anesthesia to treat total knee stiffness following total knee arthroplasty. J Arthroplasty. 2014; 29:548-52.
Kim J, Nelson CL, Lotke PA. Stiffness after total knee arthroplasty. J Bone Joint Surg Am. 2004; 86A:1479-84.
Yercan HS, Sugun TS, Bussiere C, Ait Si Selmi T, Davies A, Neyret P. Stiffness after total knee arthroplasty: prevalence,
management and outcomes. Knee. 2006; 13:111-7.
Ghandi R, de Beer J, Leone J, Petruccelli D, Winemaker M, Adili A. Predictive risk factors for stiff knees in total knee arthroplasty.
J Arthroplasty. 2006; 21:46-52.
Kahn TL, Schwarzkopf R. Does total knee arthroplasty affect physical activity levels? Datafrom the osteoarthritis initiative. J
Arthroplasty. 2015; 1-5.
Ghani H, Maffulli N, Khanduja V. Management of stiffness following total knee arthroplasty: a systematic review. Knee.
; 19: 751-59.
Hoogeboom TJ, van Meeteren NL, Schank K, Kim RH, Miner T, Stevens-Lapsley JE. Risk factors for delayed inpatient functional
recovery after total knee arthroplasty. Biomed Res Int. 2015; 1-5.
Panni AS, Cerciello S, Vasso M, Tartarone M. Stiffness in total knee arthroplasty. J Orthop Traumatol. 2009; 10:111-18.
Walton NP, Jahromi PJ, Dobson KR, Angel KR, Lewis PL, Campbell DG. Arthrofibrosis following total knee replacement; does
therapeutic warfarin make a difference? Knee.2005; 12:103-6.
Ries MD, Badalamente M. Arthrofibrosis after total knee arthroplasty. Clin Orthop Relat Res. 2000; 177–83.
Della Valle AG, Leali A, Haas S. Etiology and surgical interventions for stiff knee replacements. HSS J. 2007; 3: 182–9.
Weale AE, Murray DW, Newman JH, Ackroyd CE. The length of the patellar tendon after unicompartmental and total knee
replacement. J Bone Joint Surg Br. 1999; 81:790-5.
Brotzman BS, Wilk K. Clinical orthopedic rehabilitation. 2nd ed. Philadelphia:Mosby; 2003.
Zach A, Hendrich S, Pfeifer K. Association between exercise therapy dose and functional improvements in the early
postoperative phase after hip and knee arthroplasty: an observational study. PMR Journal 2015; 1-9.
Fitzsimmons SE, Vazquez EA, Bronson MJ. How to treat the stiff total knee arthroplasty? Clin Orthop Relat Res. 2010; 468: 1096-
Finger E, Willis FB. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report.
Cases J. 2008; 1:421.
Edwin PS, Sherwin LS, Gonzalez Della Valle A. Stifness after total knee replacement: how to not repeat surgery. Orthopedics.2010;
:3-4.
Nawghare S, Brooks S. Manipulation under anesthesia for stiffness after total knee replacement: a systematic review. J
Orthop Allied Sci. 2013 1:7-13.
Keating EM, Ritter MA, Harty LD, Haas G, Meding JB, Faris PM,et al. Manipulation after total knee arthroplasty. J Bone Joint Surg
Am. 2007; 89:282-6.
Cates HE, Schmidt JM. Closed manipulation after total knee arthroplasty: outcome and affecting variables. Orthopedics.
; 32:398.
Rubinstein RA Jr, DeHaan A. The incidence and results of manipulation after primary total knee arthroplasty. Knee. 2010;
:29-32.
Sharma V, Maheshwari AV, Tsailas PG, Ranawat AS, Ranawat CS. The results of knee manipulation for stiffness after total knee
arthroplasty with or without an intra articular steroid injection. Indian J Orthop. 2008; 42:314-8.
Heuleu JN, Neyret P. Conduite à tenir devant les raideurs postopératoires du genou. Rev Chir Orthop Reparatice Appar
Mot. 2002; 88:1S27-1S58.
Pariente GM, Lombardi AV, Berend KR, Mallory TH, Adams JB. Manipulation with prolonged epidural analgesia for treatment
of TKA complicated by arthrofibrosis. Surg Technol Int. 2006; 15:221-24.
Shoji H, Yoshino S, Komagamine. Improved range of motion with the Y/S total knee arthoplasty system. Clin Orthop Relat Res.
; 218:150-63.
Fox JL, Poss R. The role of manipulation following total knee replacement. J Bone Joint Surg Am. 1981; 63:357-62.
Bellemans J, Steenwerckx A, Brabants K, Victor J, Laumens J, Fabry G. The judet quadriceplasty: a retrospective analyses of 16
cases. Acta Orthop.1996; 62:2.
Bocell JR, Thorpe CD, Tullos HS. Arthroscopic treatment of symptomatic total knee arthroplasty. Clin Orthop. 1991; 271:125-
Jerosh J, Aldawoudy AM. Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement. Knee
Surg Sports Traumatol Arthrosc. 2007; 15:71-7.
Williams RJ Westreich GH, Siegl J, Winsord RE. Arthroscopic release of posterior cruciate ligament for stiff total knee
arthroplasties. Clin Orthop. 1996; 321:185-91.
Babis Gc, Trousdale RT, Pagnano MW, Morrey BF. Poor outcomes of isolated tibíal insert exchange and arthrolysis for the
management of stiffness following total knee arthroplasty. J Bone Joint Surg Am. 2001; 83:1534-6.
Mont MA, Seyler TH, Marulanda GA, Delanois RE, Bhave A. Surgical treatment and customized rehabilitation for stiff knee
arthroplasties. Clin Orthop. 2006; 446:193-200.
Hutchinson JRM, Parish EN, Cross MJ. Results of open arthrolysis for the treatment of stiffness after total knee replacement. J
Bone Joint Surg Br. 2005; 87:1357-60.
Haidukewych GJ, Jacofsky D, Pagnano MW, Trousdale RT. Functional results after revision of well fixed components for
stiffness after primary total knee arthroplasty for stiffness. J Arthroplasty.2005;20:133-8.
Fehring TK, Odum SM, Griffin WL, McCoy TH, Masonis JL, et al. Surgical treatment of flexion contractures after total knee
arthroplasty. J Arthroplasty. 2007; 22:305.
In Y, Kim SJ, Kwon YJ. Patellar tendon lengthening for patella infera using the Ilizarov technique. J Bone Joint Surg Br.
;89:398-400.
Downloads
How to Cite
Issue
Section
License
Copyright statement
Authors must also submit a copyright statement (as seen below) on article submission.
To the Editor-in-chief of the SPMFR Journal:
The below signed author(s) hereby state that the article
________________________________________ (ref. MFR_________) is
an original unpublished work and all facts stated are a product of the author(s) investigation. This article does not violate any copyright laws or privacy statements. The author(s) also hereby confirm that there is no conflict of interest's issues in this article.
By submitting this article the author(s) agree that after publication all copyrights belong to the SPMFR Journal.
Signed by all authors
Date:
Names (capital letters):
Signatures:
The SPMFR Journal’s contents are follow a Creative Commons licence. After publication the authors can hand out the articles as long as the SPMFR Journal is credited.
