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Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA

Manipulation under anesthesia (MUA) for stiffness within 6 to 12 weeks after mechanically aligned total knee arthroplasty (TKA) generally yields better outcome scores than an MUA performed later. However, the timing of MUA after unrestricted, caliper-verified, kinematically aligned (KA) TKA remains...

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Autores principales: Shekhar, Adithya, Howell, Stephen M., Nedopil, Alexander J., Hull, Maury L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875955/
https://www.ncbi.nlm.nih.gov/pubmed/35207792
http://dx.doi.org/10.3390/jpm12020304
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author Shekhar, Adithya
Howell, Stephen M.
Nedopil, Alexander J.
Hull, Maury L.
author_facet Shekhar, Adithya
Howell, Stephen M.
Nedopil, Alexander J.
Hull, Maury L.
author_sort Shekhar, Adithya
collection PubMed
description Manipulation under anesthesia (MUA) for stiffness within 6 to 12 weeks after mechanically aligned total knee arthroplasty (TKA) generally yields better outcome scores than an MUA performed later. However, the timing of MUA after unrestricted, caliper-verified, kinematically aligned (KA) TKA remains uncertain. A retrospective review identified 82 of 3558 (2.3%) KA TKA patients treated with an MUA between 2010 and 2017. Thirty patients treated with an MUA within 3 months of the TKA (i.e., early) and 24 in the late group (i.e., >3 months) returned a questionnaire after a mean of 6 years and 5 years, respectively. Mean outcome scores for the early vs. late group were 78 vs. 62 for the Forgotten Joint Score (FJS) (p = 0.023) and 42 vs. 39 for the Oxford Knee Score (OKS) (p = 0.037). Subjectively, the early vs. late group responses indicated that 83% vs. 67% walked without a limp, 73% vs. 54% had normal extension, and 43% vs. 25% had normal flexion. An MUA within 3 months after unrestricted KA TKA provided excellent FJS and OKS at final follow-up relative to a late MUA. A late MUA performed after 3 months is worth consideration because of the good FJS and OKS scores, albeit with a risk of a persistent limp and limitation in knee extension and flexion.
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spelling pubmed-88759552022-02-26 Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA Shekhar, Adithya Howell, Stephen M. Nedopil, Alexander J. Hull, Maury L. J Pers Med Article Manipulation under anesthesia (MUA) for stiffness within 6 to 12 weeks after mechanically aligned total knee arthroplasty (TKA) generally yields better outcome scores than an MUA performed later. However, the timing of MUA after unrestricted, caliper-verified, kinematically aligned (KA) TKA remains uncertain. A retrospective review identified 82 of 3558 (2.3%) KA TKA patients treated with an MUA between 2010 and 2017. Thirty patients treated with an MUA within 3 months of the TKA (i.e., early) and 24 in the late group (i.e., >3 months) returned a questionnaire after a mean of 6 years and 5 years, respectively. Mean outcome scores for the early vs. late group were 78 vs. 62 for the Forgotten Joint Score (FJS) (p = 0.023) and 42 vs. 39 for the Oxford Knee Score (OKS) (p = 0.037). Subjectively, the early vs. late group responses indicated that 83% vs. 67% walked without a limp, 73% vs. 54% had normal extension, and 43% vs. 25% had normal flexion. An MUA within 3 months after unrestricted KA TKA provided excellent FJS and OKS at final follow-up relative to a late MUA. A late MUA performed after 3 months is worth consideration because of the good FJS and OKS scores, albeit with a risk of a persistent limp and limitation in knee extension and flexion. MDPI 2022-02-18 /pmc/articles/PMC8875955/ /pubmed/35207792 http://dx.doi.org/10.3390/jpm12020304 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shekhar, Adithya
Howell, Stephen M.
Nedopil, Alexander J.
Hull, Maury L.
Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title_full Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title_fullStr Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title_full_unstemmed Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title_short Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA
title_sort excellent and good results treating stiffness with early and late manipulation after unrestricted caliper-verified kinematically aligned tka
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8875955/
https://www.ncbi.nlm.nih.gov/pubmed/35207792
http://dx.doi.org/10.3390/jpm12020304
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