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Topic:

​

Issue:

Knee

Category:

​

Title:

Manipulation Under Anesthesia is Safe and Effective for Management of Early Postoperative Knee Arthrofibrosis in Adolescent Patients

Author:

Marquez-Lara, Alejandro MD, PhD; Padget, William DO; Wall, Eric J. MD; Parikh, Shital N. MD

Journal:

Journal of Pediatric Orthopaedics

Date:

January 2024

Reference:

44(1): p e84-e90, DOI: 10.1097/BPO.0000000000002562

Level Of Evidence:

IV

# of Patients:

57

Study Type:

Retrospective review

Location:

Not specified

Summary:

This study evaluates the safety and efficacy of early manipulation under anesthesia (MUA) for the treatment of knee arthrofibrosis in adolescent patients. The authors hypothesized that early MUA could restore normal knee motion with a low complication rate and avoid the need for more invasive interventions.

Methods:

A retrospective analysis of 57 adolescent patients who underwent MUA for postoperative knee arthrofibrosis. Changes in range of motion (ROM) before and after MUA were analyzed. Descriptive statistics, including median and interquartile range, were used, and repeated measures ANOVA assessed improvement in ROM over time.

Exclusions:

Patients who did not undergo MUA or had insufficient follow-up.

Results:

The median age of patients at the time of MUA was 14.5 years. The median time to MUA was 64 days post-surgery. ROM improved from 90° pre-MUA to 130° post-MUA, and at the final follow-up, the average ROM was 133°. 12.3% of patients (7/57) required subsequent interventions after MUA. No iatrogenic fractures or physeal separations occurred during MUA.

Conclusions:

Early MUA (<3 months post-surgery) for knee arthrofibrosis is safe and effective in adolescents, with good ROM recovery and minimal complications. Those requiring further intervention still regained satisfactory motion. Early recognition and MUA can prevent more invasive procedures and improve outcomes.

Relevance:

Limitations:

Perspective:

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