Manipulation Under Anesthesia to Treat Postoperative Stiffness After Total Knee Arthroplasty .
The Chitranjan S. Ranawat Award: Manipulation Under Anesthesia to Treat Postoperative Stiffness After Total Knee Arthroplasty: A Multicenter Randomized Clinical Trial.
J Arthroplasty. 2024 Aug;39(8S1):S9-S14.e1.One hundred twenty-four patients with postoperative stiffness after primary TKA due to osteoarthritis were randomized to receive either MUA with PT alone (n=58) or MUA with PT plus one dose of pre-MUA intravenous dexamethasone (8 mg) and 14 days of oral celecoxib (200 mg) (n=66). The primary outcome of interest was knee ROM at 6 weeks after MUA. Secondary outcomes included knee ROM at 1 year and clinical outcome measures at both time points. Outcomes were assessed immediately after MUA, at 6 weeks, and at 1 year. Overall, the results revealed that while MUA significantly improved ROM immediately by 46°, there was no statistically significant difference between the treatment and control groups at 6 weeks or at 1 year. Clinical outcomes were also similar between groups. These findings suggest that the addition of dexamethasone and celecoxib does not enhance ROM or clinical outcomes after MUA for TKA stiffness.
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