Sunil Kumar Karadi Hari, Mamarelis Georgios, Pettit Matthew, Khanduja Vikas
Specialty Registrar in Trauma & Orthopaedics, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
Specialty Registrar in Trauma & Orthopaedics, Royal London Hospital, Whitechapel, London E1 1BB, UK.
SICOT J. 2021;7:30. doi: 10.1051/sicotj/2021008. Epub 2021 Apr 30.
Stiffness following total knee arthroplasty (TKA) is a challenging complication and can result in a poor functional outcome. There is considerable debate concerning the definition, work-up, and optimal management of this complication. The aim of this study was to record the definition of stiffness, management practices, and expectations of outcome among surgeons from an international community using a peer-reviewed questionnaire.
A 23-item peer-reviewed online questionnaire was sent to all members of SICOT to gauge and record the management practices and expectations of outcome in the management of patients with stiffness following TKA.
A total of 315 surgeons completed this peer-reviewed questionnaire. Manipulation under anaesthesia (MUA) was the preferred treatment option for stiffness post-TKA, with a majority of the surgeons opting to carry out this procedure between 6 and 12 weeks following the index TKA. Physiotherapy and a continuous passive motion device were also used by the majority of surgeons following MUA, as additional treatment measures.
MUA is perceived to be a safe and effective primary treatment option for stiffness following TKA. It is best performed between weeks 6 and 12 with expected gains in range of motion from 10 to 20 degrees in 75% of patients.
全膝关节置换术（TKA）后僵硬是一种具有挑战性的并发症，可能导致功能预后不良。关于该并发症的定义、检查及最佳治疗方法存在诸多争议。本研究的目的是通过一份经过同行评审的问卷，记录国际范围内外科医生对僵硬的定义、治疗方法及预后期望。
向国际骨科学会（SICOT）的所有成员发送一份包含23个条目的经过同行评审的在线问卷，以评估和记录TKA后僵硬患者的治疗方法及预后期望。
共有315名外科医生完成了这份经过同行评审的问卷。麻醉下手法松解（MUA）是TKA后僵硬的首选治疗方法，大多数外科医生选择在初次TKA术后6至12周进行该操作。大多数外科医生在MUA后还使用物理治疗和持续被动运动装置作为额外的治疗措施。
MUA被认为是TKA后僵硬的一种安全有效的主要治疗方法。最佳操作时间为术后6至12周，75%的患者预计活动范围可增加10至20度。
