Claude-Alain Roullet, Stéphane Descamps, Shirin Monadjemi, Aymard De Ladoucette, Cecile Batailler, Bruno Miletic, Matthieu Ehlinger
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引用次数: 0
Abstract
Introduction: knee stiffness is a common complication following total knee replacement (TKA), causing important morbidity. Although manipulation under anesthesia (MUA) is a safe method for the treatment of stiffness, its benefits over long-term and for large cohorts are not precisely known. The aim of this retrospective study was to assess clinical and functional outcomes and patients satisfaction after MUA over 5 years of follow-up.
Hypothesis: Our hypothesis was that range of motion (ROM) improvement would be superior to 30° and would be sustained at 5 years follow-up leading to a patient satisfaction rate exceeding 70%.
Material and methods: This was an observational retrospective study organized with 14 French centers implied in the SOFCOT. Three hundred and forty four patients who underwent MUA following TKA were reviewed between January 2023 and June 2024. Among the cohort, patients who underwent a second MUA were analyzed separately. The collected data included patient demographics, Devane activity, ASA score, functional scores, knee amplitudes and satisfaction rates. Statistical analysis was performed with EasyMedStat.
Results: The mean time between TKA and MUA was 2.9 ± 6.9 months and the mean follow-up was 5.5 ± 2.5 years. In comparison with the ROM at stiffness diagnosis (66.6°± 21.0°), at 5 years post-MUA, the ROM was improved by 36.0° ± 26.1 (p < 0.001), at a mean of 102.2° ± 22.6°. The subgroup of patients having a second MUA had a ROM gain of 16.8° ± 12.3° at 5-years post-MUA. The global complication rate after MUA was 2.3% (n = 8) including hematoma, wound dehiscence, infection, tibial tubercle fracture and patellar tendon rupture. At last follow-up, OKS was 35.4 ± 9.6. The KOOS for all subscales ranged from 38.5 ± 30.9 to 57.5 ± 33.8 and the mean FJS was 35.0 ± 14.3. A high satisfaction rate was recorded (77.5%).
Conclusion: The improvement in ROM was substantial throughout the 5-year follow-up period. MUA was associated with low complication rates and high patient satisfaction, suggesting that it is an effective treatment for knee stiffness.
Level of evidence: III; multicenter retrospective cohort study.
期刊介绍：
Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.
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