The stiff total knee arthroplasty: Evaluation and management

Arthrofibrosis after total knee arthroplasty is a relatively common complication. A variety of modalities have been employed to treat this problem, including physical therapy, injections, and manipulations. We examined a group of consecutive posterior stabilized total knee arthroplasties to determine the prevalence of arthrofibrosis, as defined by flexion <90°, and the effect of manipulation under anesthesia on outcome. Approximately 11% of the patients met the criteria for arthrofibrosis. Manipulation under anesthesia was successful in improving flexion from an average of 67° premanipulation to 111° postmanipulation. The group that required manipulation did as well statistically as the group as a whole, which had a mean flexion of 114° at 1 year. Copyright 2002, Elsevier Science (USA). All rights reserved.