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Early manipulation after TKA leads to improved outcomes
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Study findings showed patients who underwent earlier manipulation of the knee following total knee arthroplasty saw better clinical outcomes than those whose manipulation occurred later.
Researchers evaluated 144 patients undergoing manipulation under anesthesia after total knee arthroplasty (TKA); mean follow-up was 51 months. Manipulations performed during the first 12 weeks after TKA were defined as early; all those afterwards were defined as late.
Patients were broken down into four groups based on manipulation timing: patients who received manipulation within 6 weeks (group 1); patients who received manipulation at 7 to 12 weeks (group 2); patients who received manipulation at 13 to 26 weeks (group 3); and patients who received manipulation at later than 26 weeks (group 4).
Metrics studied included gains in both flexion and final range-of-motion (ROM) as well as Knee Society objective and function values.
The researchers found that patients who underwent earlier manipulation had significantly greater mean gain than patients in the later manipulation cohorts in flexion (36.5° and 17°, respectively) and increased final range of motion (119° and 95°, respectively). Patients in the earlier manipulation groups also had better Knee Society objective (89 and 84, respectively) and function scores (88 and 83, respectively). No significant difference between groups 1 and 2 were noted, according to the researchers.
Manipulations in Group 4 resulted in poorer clinical outcomes, leading the researchers to conclude such outcomes were associated with manipulations later than 26 weeks postoperatively.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.
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