Revision TKA yields greater range of motion, lower recurrence rate of stiffness
ORLANDO, Fla. — Patients who underwent revision total knee arthroplasty for treatment of a stiff knee experienced better range of motion and a lower recurrence rate of knee stiffness, according to a speaker here.
“Stiffness is one of the most frequent complications of total knee arthroplasty — it is multifactorial with some elements out of our control, and you can prevent it by careful patient selection, meticulous preoperative planning and surgical technique,” Edwin P. Su, MD, said at the Current Concepts of Joint Replacement Winter Meeting.
According to Su, preoperative total knee arthroplasty (TKA) stiffness is correlated with postoperative lack of motion.
There are multifactorial causes of stiffness. Su recommends that surgeons examine preoperative causes and manage patient expectations. Although surgeons automatically assume that patients will gain range of motion with TKA, surgeons should recognize that flexible patients have the ability to lose their motion.
“A close follow-up of a patient’s progress is crucial for success in return of range of motion. Should motion plateau early in the recovery phase, the patient should be evaluated for manipulation under anesthesia,” he said. “At our institution, most manipulations are performed with 3 months postoperative under an epidural anesthetic.”
Full revision is the most powerful intervention for a stiff knee, Su said.
“In looking at the review of the literature and these techniques, you can see that a revision total knee will give you the greatest gains in range of motion, with the lowest recurrence rate of stiffness. – by Nhu Te
Su EP. Paper #99. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 14-17; Orlando.
Disclosure: Su reports he has stock options from OrthAlign and receives a consulting fee from Smith & Nephew.