ArticleThe Journal of arthroplasty2021
Acquired Idiopathic Stiffness After Contemporary Total Knee Arthroplasty: Incidence, Risk Factors, and Results Over 25 Years.
Article in The Journal of arthroplasty, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 43 citations in OpenAlex.
- The Chitranjan S. Ranawat Award: Manipulation Under Anesthesia to Treat Postoperative Stiffness After Total Knee Arthroplasty: A Multicenter Randomized Clinical Trial.The Journal of arthroplasty · 2024Trial
- Reluctant knee: understanding and managing stiffness after total knee arthroplasty.International orthopaedics · 2026Review
- Arthrofibrosis After Total Knee Arthroplasty: Biological Mechanisms, Diagnosis, and Treatment: An International Consensus Symposium.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2026Article
- Design and validation of a biomechanics device for preclinical arthrofibrosis models.Bone & joint research · 2026Article
- New Clues to the Challenge of Knee Arthrofibrosis: From Molecules to Therapies.The Journal of the American Academy of Orthopaedic Surgeons · 2026Review
- Prospective clinical trial analyzing serum mast cell tryptase levels and arthrofibrosis rates after total knee arthroplasty.Bone & joint research · 2025Article
- [Revision analysis and successful solutions for my failed primary total knee arthroplasties].Orthopadie (Heidelberg, Germany) · 2025Review
- Article
- Temporal- and concentration-dependent effects of transforming growth factor-beta 1 (TGF-β1) in primary human knee fibroblasts.Bone & joint research · 2025Article
- Releasing Forces in Adhesive Capsulitis Are Important Indicators of Shoulder Stiffness and Postoperative Function.Clinical orthopaedics and related research · 2025Article
- Limited evidence for the usage of renin-angiotensin-aldosterone pathway blockers to prevent arthrofibrosis after total knee arthroplasty. A systematic review of clinical evidence.Journal of experimental orthopaedics · 2024Review
- Efficacy of ADIPOR1 and ADIPOR2 peptide-agonist AdipoRon in preventing contracture in a rabbit model of arthrofibrosis.Journal of orthopaedic research : official publication of the Orthopaedic Research Society · 2024Article
- Hemoglobin A1c Levels >6.6% Are Associated With Higher Postoperative Complications After Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2024Article
- AdipoRon reduces TGFβ1-mediated collagen deposition in vitro and alleviates knee stiffness in vivo.Journal of cellular physiology · 2024Article
- Global mapping of institutional and hospital-based (Level II-IV) arthroplasty registries: a scoping review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Research progress of knee fibrosis after anterior cruciate ligament reconstruction.Frontiers in pharmacology · 2024Review
- Nonsteroidal Anti-Inflammatory Drugs and Oral Corticosteroids Mitigated the Risk of Arthrofibrosis After Total Knee Arthroplasty.The Journal of arthroplasty · 2023Article
- Profiling the Immune Response to Periprosthetic Joint Infection and Non-Infectious Arthroplasty Failure.Antibiotics (Basel, Switzerland) · 2023Review
- Human outgrowth knee fibroblasts from patients undergoing total knee arthroplasty exhibit a unique gene expression profile and undergo myofibroblastogenesis upon TGFβ1 stimulation.Journal of cellular biochemistry · 2022Article
- Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA.Journal of personalized medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAcquired idiopathic stiffness (AIS) remains a common failure mode of contemporary total knee arthroplasties (TKAs). The present study investigated the incidence of AIS and manipulation under anesthesia (MUA) at a single institution over time, determined outcomes of MUAs, and identified risk factors associated with AIS and MUA.
methodsWe identified 9771 patients (12,735 knees) who underwent primary TKAs with cemented, modular metal-backed, posterior-stabilized implants from 2000 to 2016 using our institutional total joint registry. Mean age was 68 years, 57% were female, and mean body mass index was 33 kg/m
resultsDuring the study period, 456 knees (3.6%) developed AIS and 336 knees (2.6%) underwent MUA. Range of motion (ROM) increased a mean of 34° after the MUA; however, ROM for patients treated with MUA was inferior to patients without AIS at final follow-up (102° vs 116°, P < .0001). Significant risk factors included younger age (HR 2.3, P < .001), increased tourniquet time (HR 1.01, P < .001), general anesthesia (HR 1.3, P = .007), and diabetes (HR 1.5, P = .001).
conclusionAcquired idiopathic stiffness has continued to have an important adverse impact on the outcomes of a subset of patients undergoing primary TKAs. When utilized, MUA improved mean ROM by 34°, but patients treated with MUA still had decreased ROM compared to patients without AIS. Importantly, we identified several significant risk factors associated with AIS and subsequent MUA. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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Registered trials
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