Choi Ho-Rim, Siliski John, Malchau Henrik, Freiberg Andrew, Rubash Harry, Kwon Young-Min
Massachusetts General Hospital, Orthopaedic Surgery, Harvard Medical School, Boston, MA, USA.
Int Orthop. 2014 Aug;38(8):1641-5. doi: 10.1007/s00264-014-2421-z. Epub 2014 Jul 4.
To evaluate how often manipulation under anesthesia (MUA) can achieve functional flexion ≥ 90 degrees and identify predictor for successful outcome of MUA for stiff total knee arthroplasty (TKA).
Demographic data, range of motion, and surgical and anesthetic information of 143 MUAs were retrospectively analyzed from 2000 to 2011.
One-hundred thirty-six out of 143 patients (95 %) improved mean range of motion (ROM) from pre-MUA 62 ± 17° to final ROM 101 ± 21° (p < 0.001). Flexion ≥ 90 degrees was achieved in 74% (106/143) of patients. Regional anesthesia was identified as predictor of successful MUA outcome (p = 0.007, OR: 8.5, 95% CI: 1.2-66.7).
Although the proportion of patients regaining flexion ≥ 90 degrees following MUA was less than those patients with simple overall ROM increase, the functional flexion ≥ 90 degrees was achieved in the vast majority of patients with stiff TKA following MUA.
评估麻醉下手法松解(MUA)能达到功能位屈膝≥90度的频率,并确定僵硬全膝关节置换术(TKA)中MUA成功结局的预测因素。
回顾性分析2000年至2011年期间143例MUA患者的人口统计学数据、活动范围以及手术和麻醉信息。
143例患者中有136例(95%)平均活动范围(ROM)从MUA前的62±17°改善至最终ROM的101±21°(p<0.001)。74%(106/143)的患者达到屈膝≥90度。区域麻醉被确定为MUA成功结局的预测因素(p=0.007,OR:8.5,95%CI:1.2-66.7)。
尽管MUA后恢复屈膝≥90度的患者比例低于单纯总体ROM增加的患者,但绝大多数僵硬TKA患者在MUA后实现了功能位屈膝≥90度。