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Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty.

Publication ,  Journal Article
Newman, ET; Herschmiller, TA; Attarian, DE; Vail, TP; Bolognesi, MP; Wellman, SS
Published in: J Arthroplasty
January 2018

BACKGROUND: Knee stiffness requiring manipulation under anesthesia (MUA) is an undesirable outcome following total knee arthroplasty (TKA), but risk factors for, and optimal timing of, MUA remain unclear. METHODS: Primary TKAs performed at a single center were retrospectively reviewed. Clinical variables were compared between patients who underwent MUA and those who did not; variables that differed were utilized to identify an appropriately matched control group of non-MUA patients. The MUA group was divided into early (MUA ≤6 weeks from index) and late (>6 weeks) subgroups. Flexion values at multiple time points were compared. RESULTS: In total, 1729 TKA patients were reviewed; MUA was performed in 62 patients. Patients undergoing MUA were younger (55.2 vs 65.3 years, P < .001) and had higher rates of current smoking (21.0% vs 7.3%, P < .001) and prior procedure (59.7% vs 40.4%, P = .002), most commonly arthroscopy; a control group of patients not requiring MUA, matched on the basis of these variables, was identified. While no difference in pre-TKA flexion existed across groups, final flexion in the early MUA group (106.7°) was equivalent to that of controls (115.6°), while final flexion in the late MUA group was not (101.3°, P = .001). CONCLUSION: TKA patients undergoing MUAs were younger, more likely to be current smokers, and more likely to have undergone prior knee surgery. Even in patients with severe initial postoperative limitations in range of motion, MUA within 6 weeks may allow for final outcomes that are equivalent to those experienced by similar patients not requiring manipulation.

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Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

January 2018

Volume

33

Issue

1

Start / End Page

245 / 249

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Range of Motion, Articular
  • Postoperative Complications
  • Orthopedics
  • Musculoskeletal Manipulations
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Newman, E. T., Herschmiller, T. A., Attarian, D. E., Vail, T. P., Bolognesi, M. P., & Wellman, S. S. (2018). Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty. J Arthroplasty, 33(1), 245–249. https://doi.org/10.1016/j.arth.2017.08.002
Newman, Erik T., Thomas A. Herschmiller, David E. Attarian, Thomas P. Vail, Michael P. Bolognesi, and Samuel S. Wellman. “Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty.J Arthroplasty 33, no. 1 (January 2018): 245–49. https://doi.org/10.1016/j.arth.2017.08.002.
Newman ET, Herschmiller TA, Attarian DE, Vail TP, Bolognesi MP, Wellman SS. Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty. J Arthroplasty. 2018 Jan;33(1):245–9.
Newman, Erik T., et al. “Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty.J Arthroplasty, vol. 33, no. 1, Jan. 2018, pp. 245–49. Pubmed, doi:10.1016/j.arth.2017.08.002.
Newman ET, Herschmiller TA, Attarian DE, Vail TP, Bolognesi MP, Wellman SS. Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty. J Arthroplasty. 2018 Jan;33(1):245–249.
Journal cover image

Published In

J Arthroplasty

DOI

EISSN

1532-8406

Publication Date

January 2018

Volume

33

Issue

1

Start / End Page

245 / 249

Location

United States

Related Subject Headings

  • United States
  • Treatment Outcome
  • Time Factors
  • Risk Factors
  • Retrospective Studies
  • Range of Motion, Articular
  • Postoperative Complications
  • Orthopedics
  • Musculoskeletal Manipulations
  • Middle Aged