ArticleActa orthopaedica2022
Postoperative pain as a risk factor for stiff knee following total knee arthroplasty and excellent patientreported outcomes after manipulation under anesthesia.
Article in Acta orthopaedica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 10 citations in OpenAlex.
- Review
- The Role of Posterior Tibial Slope in Range of Motion After Total Knee Arthroplasty for Haemophilia Patients: A Retrospective Study.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Article
- Comparison of perioperative analgesia between posterior stabilized and posterior cruciate retaining prostheses following total knee arthroplasty.Scientific reports · 2025Article
- In-Hospital Pain and Opioid Consumption After Primary Total Knee Arthroplasty Compared to Primary Total Hip Arthroplasty: Results from 7330 Patients Treated in a Fast-Track Setting.Pain and therapy · 2025Article
- Manipulation under anesthesia: to do or not to do, that is the question.Acta orthopaedica · 2022Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeManipulation under anesthesia (MUA) is the first-choice treatment for stiffness following total knee arthroplasty (TKA) unresponsive to pain management and physiotherapy. Some of the predisposing factors and patient-reported outcome measures (PROMs) following MUA remain poorly studied. We retrospectively investigated the etiological risk factors and the outcomes of MUA. PATIENTS AND
methods391 TKA patients from a randomized trial comparing the use of a tourniquet and anesthesia (spinal or general) were analyzed, and patients needing MUA were identified (MUA group). We evaluated in-hospital opioid consumption, Oxford Knee Score (OKS), range of motion (ROM), and pain assessed by the Brief Pain Inventory-short form with a 1-year follow-up.
results39 (10%) MUA patients were identified. The MUA patients were younger (60 years vs. 64 years, difference -4, 95% CI -6 to -1) and had higher postoperative oxycodone consumption (66 mg vs. 51 mg, median difference 11, CI 1-22) than the no-MUA patients. The proportion of MUA patients who contacted the emergency department within 3 months because of pain was larger than that of non-MUA patients (41% vs. 12%, OR 5, CI 3-10). At the 1-year follow-up, the ROM was improved by 39° following MUA, but the total ROM was worse in the MUA group (115° vs. 124°, p < 0.001). No difference was found in the OKS between the MUA and no-MUA patients.
interpretationHigher postoperative pain seems to predict MUA risk. MUA performed 3 months postoperatively offers substantial ROM improvement and comparable PROMs to no-MUA patients 1 year after TKA.
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