Management of knee pain and stiffness after total knee arthroplasty

This article reviews 33 patients who presented with persistent pain, inadeq uate knee motion, or both after total knee arthroplasty. Of 33 patients, 26 had inadequate motion treated by closed manipulation, arthroscopic manipul ation, or a modified open release manipulation. In 23 patients, these proce dures were successful. Of the 26 patients, 85% had a history of previous kn ee surgery or diabetes mellitus. The average gain in range of motion was no t different in comparing early (< 12 weeks) manipulation versus late (> 12 weeks) manipulation. Seven of the 33 patients presenting with pain, swellin g, inadequate motion, or snapping sensations had either failure of bonding between the polymethyl methacrylate and the components (4 patients) or pain ful fibrous intra-articular bands (3 patients). These patients were treated successfully either by recementing the components or by arthroscopic fibro us band release.