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Prognostic factors that predict failure of manipulation under anesthesia for the stiff total knee arthroplasty: A systematic review.预测僵硬全膝关节置换术麻醉下手法治疗失败的预后因素：一项系统评价。
J Orthop. 2018 Aug 16;15(3):842-846. doi: 10.1016/j.jor.2018.08.003. eCollection 2018 Sep.
2
Manipulation under anesthesia for post traumatic stiff knee-pearls, pitfalls and risk factors for failure.创伤后膝关节僵硬的麻醉下手法治疗——要点、陷阱及失败的危险因素
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Effect of repeated manipulation on range of motion in patients with stiff total knee arthroplasty.反复手法治疗对全膝关节置换术后僵硬患者活动范围的影响。
Orthopedics. 2015 Mar;38(3):e157-62. doi: 10.3928/01477447-20150305-51.
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Predictors of outcome after manipulation under anaesthesia in patients with a stiff total knee arthroplasty.全膝关节置换僵硬患者麻醉下手法治疗后预后的预测因素
Knee Surg Sports Traumatol Arthrosc. 2017 Nov;25(11):3637-3643. doi: 10.1007/s00167-016-4413-6. Epub 2016 Dec 29.
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Manipulation under anaesthesia for stiffness following knee arthroplasty.膝关节置换术后僵硬的麻醉下手法治疗
Ann R Coll Surg Engl. 2009 Apr;91(3):220-3. doi: 10.1308/003588409X359321. Epub 2008 Dec 19.
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Manipulation under anaesthesia post total knee replacement: long term follow up.全膝关节置换术后麻醉下手法治疗：长期随访
Knee. 2012 Aug;19(4):329-31. doi: 10.1016/j.knee.2011.05.009. Epub 2011 Jun 23.
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Risk factors for failure of manipulation under anesthesia in posttraumatic knee stiffness.创伤后膝关节僵硬患者麻醉下手法治疗失败的危险因素。
Injury. 2023 Oct;54(10):111004. doi: 10.1016/j.injury.2023.111004. Epub 2023 Aug 21.
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Risk Factors, Outcomes, and Timing of Manipulation Under Anesthesia After Total Knee Arthroplasty.全膝关节置换术后全身麻醉下手法复位的危险因素、结果和时机。
J Arthroplasty. 2018 Jan;33(1):245-249. doi: 10.1016/j.arth.2017.08.002. Epub 2017 Aug 10.

引用本文的文献

1
Range-of-Motion Predictors for Repeat Manipulation Under Anesthesia and Revision Surgery for Stiffness After Total Knee Arthroplasty.全膝关节置换术后僵硬的麻醉下重复手法治疗及翻修手术的活动度预测因素
HSS J. 2025 May;21(2):166-173. doi: 10.1177/15563316241254086. Epub 2024 May 14.
2
Manipulation under anesthesia: to do or not to do, that is the question.麻醉下手法治疗：做还是不做，这是个问题。
Acta Orthop. 2022 Jul 15;93:682-683. doi: 10.2340/17453674.2022.4344.
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Patients undergoing manipulation after total knee arthroplasty are at higher risk of revision within 2 years.接受全膝关节置换术后进行手法治疗的患者在 2 年内再次手术的风险更高。
Eur J Orthop Surg Traumatol. 2022 Jan;32(1):145-150. doi: 10.1007/s00590-021-02943-z. Epub 2021 Mar 24.

本文引用的文献

1
International consensus on the definition and classification of fibrosis of the knee joint.膝关节纤维化定义与分类的国际共识。
Bone Joint J. 2016 Nov;98-B(11):1479-1488. doi: 10.1302/0301-620X.98B10.37957.
2
Prospective Randomized Trial of the Efficacy of Continuous Passive Motion Post Total Knee Arthroplasty: Experience of the Hospital for Special Surgery.全膝关节置换术后持续被动运动效果的前瞻性随机试验：特种外科医院的经验
J Arthroplasty. 2015 Dec;30(12):2364-9. doi: 10.1016/j.arth.2015.06.006. Epub 2015 Jun 14.
3
The effect of timing of manipulation under anesthesia to improve range of motion and functional outcomes following total knee arthroplasty.麻醉下手法复位对改善全膝关节置换术后关节活动度和功能结果的时机影响。
J Bone Joint Surg Am. 2014 Aug 20;96(16):1349-57. doi: 10.2106/JBJS.M.00899.
4
How often is functional range of motion obtained by manipulation for stiff total knee arthroplasty?对于僵硬的全膝关节置换术，通过手法操作获得功能活动范围的频率是多少？
Int Orthop. 2014 Aug;38(8):1641-5. doi: 10.1007/s00264-014-2421-z. Epub 2014 Jul 4.
5
Predictors of range of motion in patients undergoing manipulation after TKA.全膝关节置换术后手法治疗患者关节活动度的预测因素。
Clin Orthop Relat Res. 2013 Jan;471(1):258-63. doi: 10.1007/s11999-012-2591-1.
6
Preoperative knee stiffness and total knee arthroplasty outcomes.术前膝关节僵硬与全膝关节置换术的结局。
J Arthroplasty. 2012 Sep;27(8):1437-41. doi: 10.1016/j.arth.2011.12.015. Epub 2012 Jan 27.
7
Arthrofibrosis after TKA - Influence factors on the absolute flexion and gain in flexion after manipulation under anaesthesia.全膝关节置换术后的关节纤维性僵直——麻醉下手法松解后关节绝对屈曲度和屈曲度增加的影响因素。
BMC Musculoskelet Disord. 2011 Aug 12;12:184. doi: 10.1186/1471-2474-12-184.
8
Manipulation under anaesthesia post total knee replacement: long term follow up.全膝关节置换术后麻醉下手法治疗：长期随访
Knee. 2012 Aug;19(4):329-31. doi: 10.1016/j.knee.2011.05.009. Epub 2011 Jun 23.
9
Mast cells and hypoxia drive tissue metaplasia and heterotopic ossification in idiopathic arthrofibrosis after total knee arthroplasty.肥大细胞和缺氧驱动全膝关节置换术后特发性关节纤维性变中的组织化生和异位骨化。
Fibrogenesis Tissue Repair. 2010 Sep 1;3:17. doi: 10.1186/1755-1536-3-17.
10
The incidence and results of manipulation after primary total knee arthroplasty.初次全膝关节置换术后手法治疗的发生率及结果
Knee. 2010 Jan;17(1):29-32. doi: 10.1016/j.knee.2009.07.001. Epub 2009 Aug 6.

预测僵硬全膝关节置换术麻醉下手法治疗失败的预后因素：一项系统评价。

Prognostic factors that predict failure of manipulation under anesthesia for the stiff total knee arthroplasty: A systematic review.

作者信息

Gu Alex, Michalak Adam J, Cohen Jordan S, Stepan Jeffrey G, Almeida Neil D, McLawhorn Alexander S, Sculco Peter K

机构信息

Department of Medicine, George Washington School of Medicine and Health Sciences, 2300 Eye St, Washington, DC 20037, USA.

Complex Joint Reconstruction Center, Hospital for Special Surgery, 535 E 70th St, New York, NY 10021, USA.

出版信息

J Orthop. 2018 Aug 16;15(3):842-846. doi: 10.1016/j.jor.2018.08.003. eCollection 2018 Sep.

DOI:10.1016/j.jor.2018.08.003
PMID:30140131
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6104526/
Abstract

PURPOSE

Prognostic factors associated with Manipulation under anesthesia (MUA) failure remain unknown.

METHODS

A systematic review of the literature was performed to identify studies that reported prognostic factors associated with MUA for postoperative stiffness.

RESULTS

7 studies analyzing prognostic factors associated with MUA outcomes were included. Several studies note pre-MUA ROM to be a significant prognostic factor affecting post-MUA ROM at final follow-up. Knees with <70° of flexion pre-MUA had less final flexion arc than those with >70°.

CONCLUSIONS

The strongest prognostic factor for decreased ROM after MUA is severe pre-MUA stiffness.

摘要

目的

与麻醉下手法治疗（MUA）失败相关的预后因素仍不清楚。

方法

对文献进行系统综述，以确定报告与MUA治疗术后僵硬相关预后因素的研究。

结果

纳入了7项分析与MUA结果相关预后因素的研究。几项研究指出，MUA前的关节活动度（ROM）是影响最终随访时MUA后ROM的一个重要预后因素。MUA前屈曲<70°的膝关节最终屈曲弧度小于屈曲>70°的膝关节。

结论

MUA后ROM降低的最强预后因素是MUA前的严重僵硬。