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Manipulation under anaesthesia versus low stretch device in poor range of motion after TKA

Erik Witvrouw UGent, Johan Bellemans and Jan Victor UGent (2013) KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 21(12). p.2751-2758
abstract
The purpose of this study was to evaluate the effectiveness of two frequently used non-operative treatment techniques for a stiff knee after total knee arthroplasty. Sixty-four patients with a stiff knee after total knee arthroplasty (TKA) were randomized into a manipulation under anaesthesia group, or a low load stretch (stretch) group. The patients were followed up for 6 weeks and were evaluated for maximum flexion and extension, range of motion (ROM), pain, stiffness and function. Both groups showed a significant increase in knee flexion in this study. Only the stretch group showed a significant increase in extension ROM. In both groups, a significant increase in Western Ontario and McMaster Universities was observed. No significant difference was observed between both groups for the flexion or extension ROM, or for any of the pain, function or stiffness scores during this study. The results of this study showed that the stretch technique had equal or superior results concerning ROM and function compared to manipulation under anaesthesia. The stretch technique achieved this without requiring the patient to undergo in-hospital treatment or anaesthesia, limiting the costs and the risks for complications. The results of this study showed that stretching is a valuable tool for treating joint contractures of the knee. Therefore, the use of this stretching technique may be an excellent first choice of treatment modality in patients with slow progress of knee flexion or persistent knee stiffness following TKA, prior to manipulation under anaesthesia or lysis of adhesions.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MANAGEMENT, STIFFNESS, ARTHROFIBROSIS, PREVALENCE, OUTCOMES, Range of motion, Total Knee arthroplasty, CEREBRAL-PALSY, PATELLAR TENDON, FLEXION CONTRACTURES, TOTAL KNEE ARTHROPLASTY, STATIC PROGRESSIVE STRETCH, Treatment, Stretch
journal title
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
Knee Surg. Sports Traumatol. Arthrosc.
volume
21
issue
12
pages
2751 - 2758
Web of Science type
Article
Web of Science id
000327084800017
JCR category
SPORT SCIENCES
JCR impact factor
2.837 (2013)
JCR rank
10/81 (2013)
JCR quartile
1 (2013)
ISSN
0942-2056
DOI
10.1007/s00167-012-2152-x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
3003386
handle
http://hdl.handle.net/1854/LU-3003386
date created
2012-10-01 14:46:02
date last changed
2013-12-19 15:12:44
@article{3003386,
  abstract     = {The purpose of this study was to evaluate the effectiveness of two frequently used non-operative treatment techniques for a stiff knee after total knee arthroplasty.
Sixty-four patients with a stiff knee after total knee arthroplasty (TKA) were randomized into a manipulation under anaesthesia group, or a low load stretch (stretch) group. The patients were followed up for 6 weeks and were evaluated for maximum flexion and extension, range of motion (ROM), pain, stiffness and function.
Both groups showed a significant increase in knee flexion in this study. Only the stretch group showed a significant increase in extension ROM. In both groups, a significant increase in Western Ontario and McMaster Universities was observed. No significant difference was observed between both groups for the flexion or extension ROM, or for any of the pain, function or stiffness scores during this study.
The results of this study showed that the stretch technique had equal or superior results concerning ROM and function compared to manipulation under anaesthesia. The stretch technique achieved this without requiring the patient to undergo in-hospital treatment or anaesthesia, limiting the costs and the risks for complications. The results of this study showed that stretching is a valuable tool for treating joint contractures of the knee. Therefore, the use of this stretching technique may be an excellent first choice of treatment modality in patients with slow progress of knee flexion or persistent knee stiffness following TKA, prior to manipulation under anaesthesia or lysis of adhesions.},
  author       = {Witvrouw, Erik and Bellemans, Johan and Victor, Jan},
  issn         = {0942-2056},
  journal      = {KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY},
  keyword      = {MANAGEMENT,STIFFNESS,ARTHROFIBROSIS,PREVALENCE,OUTCOMES,Range of motion,Total Knee arthroplasty,CEREBRAL-PALSY,PATELLAR TENDON,FLEXION CONTRACTURES,TOTAL KNEE ARTHROPLASTY,STATIC PROGRESSIVE STRETCH,Treatment,Stretch},
  language     = {eng},
  number       = {12},
  pages        = {2751--2758},
  title        = {Manipulation under anaesthesia versus low stretch device in poor range of motion after TKA},
  url          = {http://dx.doi.org/10.1007/s00167-012-2152-x},
  volume       = {21},
  year         = {2013},
}

Chicago
Witvrouw, Erik, Johan Bellemans, and Jan Victor. 2013. “Manipulation Under Anaesthesia Versus Low Stretch Device in Poor Range of Motion After TKA.” Knee Surgery Sports Traumatology Arthroscopy 21 (12): 2751–2758.
APA
Witvrouw, E., Bellemans, J., & Victor, J. (2013). Manipulation under anaesthesia versus low stretch device in poor range of motion after TKA. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 21(12), 2751–2758.
Vancouver
1.
Witvrouw E, Bellemans J, Victor J. Manipulation under anaesthesia versus low stretch device in poor range of motion after TKA. KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY. 2013;21(12):2751–8.
MLA
Witvrouw, Erik, Johan Bellemans, and Jan Victor. “Manipulation Under Anaesthesia Versus Low Stretch Device in Poor Range of Motion After TKA.” KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 21.12 (2013): 2751–2758. Print.