Evidence map›Paper›PMID 35301559›Full record

SynthesisInternational orthopaedics2022

Treatment of arthrofibrosis and stiffness after total knee arthroplasty: an updated review of the literature.

Amer Haffar, Graham S Goh, Yale A Fillingham, Michael T Torchia, Jess H Lonner

Registry-linked trialAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07767097 (Treatment of Acquired Idiopathic Stiffness in Revision Total Knee Arthroplasty With Hinged Knee Prosthesis With or Without Low Dose Irradiation), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
7.2field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07767097 narecruitingnot on this mapstarted 2026, after this paper: background citation

Treatment of Acquired Idiopathic Stiffness in Revision Total Knee Arthroplasty With Hinged Knee Prosthesis With or Without Low Dose Irradiation: A Multicentre Prospective Randomized Controlled Trial

TypeinterventionalSponsorMount Sinai Hospital, CanadaRan2026 to 2029Enrolled36ConditionsArthrofibrosis of KneeArmsLow-Dose External Beam Irradiation, Hinged Revision Total Knee Arthroplasty
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Displaced Bucket-handle Meniscus Tear After Total Knee Arthroplasty: A Case Report.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
    Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Observational
  12. Review
  13. Article
  14. Article
  15. Review
  16. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Amer HaffarRothman Orthopaedic Institute, 125 S 9th Street, Suite 1000, Philadelphia, PA, 19107, USA.
Graham S GohRothman Orthopaedic Institute, 125 S 9th Street, Suite 1000, Philadelphia, PA, 19107, USA.
Yale A FillinghamRothman Orthopaedic Institute, 125 S 9th Street, Suite 1000, Philadelphia, PA, 19107, USA.
Michael T TorchiaDepartment of Orthopaedic Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA.
Jess H LonnerRothman Orthopaedic Institute, 125 S 9th Street, Suite 1000, Philadelphia, PA, 19107, USA. jess.lonner@rothmanortho.com.
Rothman Orthopaedics · USDartmouth–Hitchcock Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is currently no consensus regarding the optimal treatment for stiffness following total knee arthroplasty (TKA). With the increased utilization of value-based models, it is important to determine the most effective treatments that will reduce the need for further intervention and additional expenditure. A systematic review was performed to compare the outcomes of manipulation under anaesthesia (MUA), arthroscopic lysis of adhesions (aLOA), and revision TKA (rTKA) for arthrofibrosis and stiffness following TKA.

methodsPubMed and MEDLINE databases were reviewed for articles published through October 2020. Studies were included if they reported patient-reported outcome measures (PROMs) following MUA, aLOA, or rTKA. The primary endpoint was PROMs, while secondary outcomes included range of motion and the percentage of patients who pursued further treatment for stiffness.

resultsA total of 40 studies were included: 21 on rTKA, 7 on aLOA, and 14 on MUA. The mean or median post-operative arc ROM was > 90° in 6/20 (30%) rTKA, 5/7 (71%) aLOA, and 7/10 (70%) MUA studies. Post-operative Knee Society (KSS) clinical and functional scores were the greatest in patients who underwent MUA and aLOA. As many as 43% of rTKA patients required further care compared to 25% of aLOA and 17% of MUA patients.

conclusionStiffness following TKA remains a challenging condition to treat. Nonetheless, current evidence suggests that patients who undergo rTKA have poorer clinical outcomes and a greater need for further treatment compared to patients who undergo MUA or aLOA.

Indexed as

Arthroplasty, Replacement, KneeJoint DiseasesHumansKnee JointRange of Motion, ArticularRetrospective StudiesTreatment OutcomeArthrofibrosisArthroscopic lysis of adhesionsComplicationManipulation under anesthesiaOutcomesRange of motionRevision total knee arthroplastyStiffnessSystematic review

Identifiers

PMID35301559
OpenAlexW4221089435

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.