Abstract

MANIPULATION UNDER ANESTHESIA FOR STIFFNESS AFTER TOTAL KNEE REPLACEMENT: A SYSTEMATIC REVIEW

Dr. M. R. Rajasekar and *Dr. J. T. Allen Tilak

Abstract

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

Keywords: Manipulation, stiffness, total knee replacement.