Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb;86(1):86-91.
doi: 10.3109/17453674.2014.964615. Epub 2014 Sep 30.

Low manipulation prevalence following fast-track total knee arthroplasty

Henrik Husted  1 , Christoffer C Jørgensen, Kirill Gromov, Anders Troelsen; Collaborative Group of the Lundbeck Foundation Center for Fast-Track Hip and Knee Replacement
Collaborators, Affiliations

Low manipulation prevalence following fast-track total knee arthroplasty

Henrik Husted et al. Acta Orthop. 2015 Feb.

Abstract

Background and purpose: Postoperative joint stiffness following total knee arthroplasty (TKA) may compromise the outcome and necessitate manipulation. Previous studies have not been in a fast-track setting with optimized pain treatment, early mobilization, and short length of stay (LOS), which may have influenced the prevalence of joint stiffness and subsequent manipulation. We investigated the prevalence of manipulation following fast-track TKA and identified patients at risk of needing manipulation.

Patients and methods: 3,145 consecutive unselected elective primary unilateral TKA patients operated in 6 departments with well-defined fast-track settings were included in the study. Demographic data, prevalence, type and timing of manipulation, and preoperative and postoperative ROM were recorded prospectively, ensuring complete 1-year follow-up.

Results: 70 manipulations were performed within 1 year (2.2%) at a mean of 4 months after index surgery. Younger age and not using walking aids preoperatively were associated with a higher risk of manipulation. LOS ≤ 4 days (as opposed to a longer LOS) was not associated with an increased risk of manipulation.

Interpretation: The prevalence of manipulation was lower or comparable to that in most published studies following more conventional pathways. Inherent patient demographics were identified as risk factors for manipulation whereas LOS ≤ 4 days was not. Thus, fast-track TKA does not result in increased risk of manipulation-despite a shorter LOS. Optimized pain treatment and early mobilization may contribute to these favorable results that support the use of fast-track.

PubMed Disclaimer

References

    1. Andersen TF, Madsen M, Jørgensen J, Mellemkjoer L, Olsen JH. The Danish National Hospital register. A valuable source of data for mod... . Dan Med Bull. 1999;46(3):263–8. - PubMed
    1. Barnes CL, Lincoln D, Wilson B, Bushmaier M. Knee manipulation after total knee arthroplasty: comparison of two impla... . J Surg Orthop Adv. 2013;22(2):157–9. - PubMed
    1. Bawa HS, Wera GD, Kraay MJ, Marcus RE, Goldberg VM. Predictors of range of motion in patients undergoing manipulation after TKA . Clin Orthop Relat Res. 2013;471:258–63. - PMC - PubMed
    1. Bédard M, Vince KG, Redfern J, Collen SR. Internal rotation of the tibial component is frequent in stiff total kne... . Clin Orthop Relat Res. 2011;469(8):2346–55. - PMC - PubMed
    1. Berend KR, Lombardi A V, Jr, Adams JB. Which total knee replacement implant should I pick? Correcting the pathology: the role of knee bearing designs. Bone Joint J. 2013;95-B(11 suppl A):129–32. - PubMed

Publication types

LinkOut - more resources