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Manipulation under anaesthesia shows increased ROM in total knee replacement

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DUBLIN — Manipulation under anesthesia increases the range of motion after total knee replacement procedures that yield stiff postoperative results, according a presentation by David Yeoh at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011, here.

“The range of motion is maintained in long-term, and there is no difference with respect to pre-TKR [total knee replacement] range of motion. We found no difference in the timing of MUA [manipulation under anaesthesia],” Yeoh said.

Yeoh and his team conducted a 15-year study analyzing patients’ range of motion over an average of 7.5 years in one center after a TKR. Postoperatively, 2.3% of patients underwent MUA for a mean of 12.3 weeks. There was no difference in range of motion between knees that underwent MUA before or after the 12-week recovery period.

Preoperatively, the mean flexion was 53° under MUA, which increased to 97° immediately after surgery. At the 12-month follow-up, the mean flexion was 87°, and at 10-year follow-up, the mean flexion was 86°. Yeoh said there was no difference found in the knees which had a pre-TKR flexion of greater than or less than 90°. There were no complications as a result of MUA, the authors wrote.

Reference:

• N Yeoh D, Nicolaou N, Goddard R, et al. Manipulation under anaesthesia post total knee replacement: long term follow up. Paper #238. Presented at the British Orthopaedic Association and the Irish Orthopaedic Association Combined Meeting 2011. Sept. 13-19. Dublin.
• Disclosure: Yeoh has no relevant financial disclosures.

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