Year : 2013  |  Volume : 1  |  Issue : 1  |  Page : 7-13

Manipulation under anesthesia for stiffness after total knee replacement: A systematic review

Department of Trauma & Orthopaedics, Heart of England, NHS Trust, Birmingham, United Kingdom

Correspondence Address:
Shishir Nawghare
28, Lighthorne Road, Solihull, West Midlands, B912BD
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2319-2585.117381

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Introduction: Stiffness following total knee replacement (TKR) is a debilitating complication. Manipulation under anesthesia (MUA), arthroscopy, and open arthrolysis are used to treat the stiffness. Objectives: The aim of the review was to answer the following questions. What is the gain in range of motion (ROM) after MUA for stiffness following TKR? Is the gain in ROM after MUA for stiffness following TKR retained at the last follow-up? What is the gender distribution amongst the patients presenting for MUA following TKR? What is the mean age of the patients presenting for MUA following TKR? What is the influence of timing of MUA following TKR on the ROM? The review was aimed towards establishing the current available evidence regarding MUA for stiffness. Materials and Methods: A systematic review of the current available literature was performed and the relevant studies were critically appraised. Results: Nine studies were identified to be relevant to the review (1-Level 2; 2-Level 3; 6-Level 4). It was found that there was a gain in the ROM after MUA and it was retained at the final follow-up. The patients presenting for MUA were younger and were predominantly females. Early MUA was found to be more effective, although late MUA was also beneficial. Conclusions: With limited and low quality of evidence, it is not possible to draw any conclusions.

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