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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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/2/304 |
| _version_ | 1797478747248525312 |
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| author | Adithya Shekhar Stephen M. Howell Alexander J. Nedopil Maury L. Hull |
| author_facet | Adithya Shekhar Stephen M. Howell Alexander J. Nedopil Maury L. Hull |
| author_sort | Adithya Shekhar |
| collection | DOAJ |
| 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) (<i>p</i> = 0.023) and 42 vs. 39 for the Oxford Knee Score (OKS) (<i>p</i> = 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. |
| first_indexed | 2024-03-09T21:36:59Z |
| format | Article |
| id | doaj.art-1c3886b0b4e04e869690b89ad1ec3326 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T21:36:59Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-1c3886b0b4e04e869690b89ad1ec33262023-11-23T20:41:19ZengMDPI AGJournal of Personalized Medicine2075-44262022-02-0112230410.3390/jpm12020304Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKAAdithya Shekhar0Stephen M. Howell1Alexander J. Nedopil2Maury L. Hull3California Northstate University School of Medicine, Elk Grove, CA 95758, USADepartment of Biomedical Engineering, University of California, Davis, CA 95616, USAAdventist Health Lodi Memorial, Lodi, CA 95240, USADepartment of Biomedical Engineering, University of California, Davis, CA 95616, USAManipulation 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) (<i>p</i> = 0.023) and 42 vs. 39 for the Oxford Knee Score (OKS) (<i>p</i> = 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.https://www.mdpi.com/2075-4426/12/2/304reoperationrevisionimplant survivalforgotten joint scoreOxford knee score |
| spellingShingle | Adithya Shekhar Stephen M. Howell Alexander J. Nedopil Maury L. Hull Excellent and Good Results Treating Stiffness with Early and Late Manipulation after Unrestricted Caliper-Verified Kinematically Aligned TKA Journal of Personalized Medicine reoperation revision implant survival forgotten joint score Oxford knee score |
| 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 | reoperation revision implant survival forgotten joint score Oxford knee score |
| url | https://www.mdpi.com/2075-4426/12/2/304 |
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