School of Medicine and Health Sciences Poster Presentations

Title

Prognostic Factors that Predict Failure of Manipulation Under Anesthesia for the Stiff Total Knee Arthroplasty: A Systematic Review

Poster Number

185

Document Type

Poster

Status

Medical Student

Abstract Category

Clinical Specialties

Keywords

Manipulation under Anesthesia, Stiffness, Total Knee Arthroplasty, Review, Prognostic Factors

Publication Date

Spring 2018

Abstract

Purpose: Failure to maintain a functional arc of motion following primary total knee arthroplasty (TKA) causes significant impairment and patient dissatisfaction. Manipulation under anesthesia (MUA) remains a validated treatment for post-operative stiffness. However, prognostic factors associated with MUA failure remain unknown.

Methods: A systematic review of the literature was performed to identify studies that reported prognostic factors associated with adverse clinical outcomes for patients who underwent MUA for post-operative stiffness.

Results: 7 studies analyzing prognostic factors associated with MUA outcomes were included. Several studies note pre-MUA ROM to be a significant prognostic factor affecting post-MUA ROM at final follow-up. Knees with <70 degrees of flexion pre-MUA had less final flexion arc than those with >70 degrees of flexion pre-MUA.

Conclusions: The strongest prognostic factor for decreased ROM after MUA is severe pre-MUA stiffness. However, even among this challenging group of patients, a substantial gain in function is still expected with MUA.

Prospero Registration Number: CRD42016052215

Funding: No funding was used for this project; the authors identify no conflicts of interest.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Prognostic Factors that Predict Failure of Manipulation Under Anesthesia for the Stiff Total Knee Arthroplasty: A Systematic Review

Purpose: Failure to maintain a functional arc of motion following primary total knee arthroplasty (TKA) causes significant impairment and patient dissatisfaction. Manipulation under anesthesia (MUA) remains a validated treatment for post-operative stiffness. However, prognostic factors associated with MUA failure remain unknown.

Methods: A systematic review of the literature was performed to identify studies that reported prognostic factors associated with adverse clinical outcomes for patients who underwent MUA for post-operative stiffness.

Results: 7 studies analyzing prognostic factors associated with MUA outcomes were included. Several studies note pre-MUA ROM to be a significant prognostic factor affecting post-MUA ROM at final follow-up. Knees with <70 degrees of flexion pre-MUA had less final flexion arc than those with>70 degrees of flexion pre-MUA.

Conclusions: The strongest prognostic factor for decreased ROM after MUA is severe pre-MUA stiffness. However, even among this challenging group of patients, a substantial gain in function is still expected with MUA.

Prospero Registration Number: CRD42016052215

Funding: No funding was used for this project; the authors identify no conflicts of interest.