Stiffness After Total Knee Arthroplasty: Prevalence and Treatment Outcome.

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Abstract

Conflict of interest statement: The authors have declared that no competing interests exist. 14. Eur J Orthop Surg Traumatol. 2025 Mar 21;35(1):128. doi: 10.1007/s00590-025-04245-0. Comparison of outcomes and revision free survival of early arthrofibrosis management after total knee replacement: a national cohort analysis. Sanghvi PA(1), Xu C(1), Baker J(1), Hecht C(1), Kamath AF(2)(3). Author information: (1)Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. (2)Case Western Reserve University School of Medicine, Cleveland, Ohio, USA. axk1321@case.edu. (3)Cleveland Orthopedic and Spine Institute, Mayfield Heights, Ohio, USA. axk1321@case.edu. PURPOSE: This study examined three common treatment options for arthrofibrosis treatment after total knee arthroplasty (TKA)-manipulation under anesthesia (MUA), arthroscopic lysis of adhesions (LOA), and revision TKA (rTKA)-and evaluated differences in medical outcomes, orthopedic outcomes, and revision free survivorship. METHODS: The TriNetX platform was queried to identify patients with arthrofibrosis after TKA. Cohorts were stratified by treatment and matched based on demographics and comorbidities. Differences in short-term medical complications, long-term orthopedic complications, and revision free survivorship were assessed. Odds ratios were used to compare outcomes, and Kaplan-Meier analysis was conducted to determine survivorship. RESULTS: 30,142 patients were identified with arthrofibrosis after TKA (3.61%). Within one year of diagnoses, 3,617 patients were treated with MUA, 2,022 with rTKA, 489 with LOA, and 635 patients with rTKA after MUA/LOA. At 90 days, rTKA had a higher risk of acute kidney injury, pulmonary embolism, wound dehiscence, emergency department visits, and readmission compared to MUA, and lower risk of readmission compared to patients with prior MUA/LOA (P