Range of Motion at Discharge Predicts Need for Manipulation following Total Knee Arthroplasty

LaHaise, Kristen; Vargo, Daniel V.; Barrazueta, Gustavo; Nairus, James G.; Bono, James V.; Talmo, Carl T.

doi:10.1055/s-0039-1694024

Cited by 3 publications

(1 citation statement)

References 12 publications

(18 reference statements)

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“…Risk factors for stiff knee include being African American, female, less than 60 years old, nicotine use [3] and multiple surgeries [4]. LaHaise et al [5] report that discharge range of motion (ROM) is a reliable predictor of stiff knee. However, they also report that BMI is negatively related to the frequency of stiff knee.…”

Section: Introductionmentioning

confidence: 99%

A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement

Freeman

2019

GJOR

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Stiff knee occurs in between 2% and 23% of total knee arthroplasty patients. Resolution of a stiff knee is critical for patients' quality of life following a TKA. Historically, treatment options include physical therapy, manipulation under anesthesia, arthroscopic lysis, and open lysis. Excluding physical therapy, the other options all require anesthesia, with procedures usually being done in a hospital or surgical center. Here, we report on a new non-surgical alternative that is done in patients' homes and is as efficacious as a manipulation under anesthesia.

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Section: Introductionmentioning

confidence: 99%

A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement

Freeman

2019

GJOR

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Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II–IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II–IV JARs must be created to effectively assess and categorize these data. Methods Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II–IV JARs worldwide. The secondary aim was to record their lifetime, publications’ number and frequency and recognise differences with national JARs. Results One hundred five Level II–IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case–control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies. Conclusions This is the first study mapping all Level II–IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.

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Manipulation under anaesthesia after primary total knee arthroplasty

Chalmers

Goytizolo

Mishu

et al. 2021

The Bone & Joint Journal

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Aims Manipulation under anaesthesia (MUA) remains an effective intervention to address restricted range of motion (ROM) after total knee arthroplasty (TKA) and occurs in 2% to 3% of primary TKAs at our institution. Since there are few data on the outcomes of MUA with different anaesthetic methods, we sought to compare the outcomes of patients undergoing MUA with intravenous (IV) sedation and neuraxial anaesthesia. Methods We identified 548 MUAs after primary TKA (136 IV sedation, 412 neuraxial anaesthesia plus IV sedation) from March 2016 to July 2019. The mean age of this cohort was 62 years (35 to 88) with a mean body mass index of 31 kg/m2 (18 to 49). The mean time from primary TKA to MUA was 10.2 weeks (6.2 to 24.3). Pre-MUA ROM was similar between groups; overall mean pre-MUA extension was 4.2° (p = 0.452) and mean pre-MUA flexion was 77° (p = 0.372). We compared orthopaedic complications, visual analogue scale (VAS) pain scores, length of stay (LOS), and immediate and three-month follow-up knee ROM between these groups. Results Following MUA, patients with IV sedation had higher mean VAS pain scores of 5.2 (SD 1.8) compared to 4.1 (SD = 1.5) in the neuraxial group (p < 0.001). The mean LOS was shorter in patients that received IV sedation (9.5 hours (4 to 31)) compared to neuraxial anaesthesia (11.9 hours (4 to 51)) (p = 0.009), but an unexpected overnight stay was similar in each group (8.6%). Immediate-post MUA ROM was 1° to 121° in the IV sedation group and 0.9° to 123° in the neuraxial group (p = 0.313). Three-month follow-up ROM was 2° to 108° in the IV sedation group and 1.9° to 110° in the neuraxial anaesthesia group (p = 0.325) with a mean loss of 13° (ranging from 5° gain to 60° loss), in both groups by three months. No patients in either group sustained a complication. Conclusion IV sedation alone and neuraxial anaesthesia are both effective anaesthetic methods for MUA after primary TKA. Surgeons and anaesthetists should offer these anaesthetic techniques to match patient-specific needs as the orthopaedic outcomes are similar. Also, patients should be counselled that ROM following MUA may decrease over time. Cite this article: Bone Joint J 2021;103-B(6 Supple A):126–130.

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Range of Motion at Discharge Predicts Need for Manipulation following Total Knee Arthroplasty

Cited by 3 publications

References 12 publications

A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement

A New Non-Surgical Alternative to Manipulations Under Anesthesia Following Knee Replacement

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Manipulation under anaesthesia after primary total knee arthroplasty

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