{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:10:06Z","timestamp":1789578606360,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Cedars-Sinai Medical Library"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Arthrofibrosis after primary total knee arthroplasty (TKA) is a significant contributor to patient dissatisfaction. While treatment algorithms involve early physical therapy and manipulation under anaesthesia (MUA), some patients ultimately require revision TKA. It is unclear whether revision TKA can consistently improve these patient's range of motion (ROM). The purpose of this study was to evaluate ROM when revision TKA was performed for arthrofibrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of 42 TKA\u2019s diagnosed with arthrofibrosis from 2013 to 2019 at a single institution with a minimum 2\u2010year follow\u2010up was performed. The primary outcome was ROM (flexion, extension, and total arc of motion) before and after revision TKA, and secondary outcomes included patient reported outcomes information system (PROMIS) scores. Categorical data were compared using chi\u2010squared analysis, and paired samples <jats:italic>t<\/jats:italic> tests were performed to compare ROM at three different times: pre\u2010primary TKA, pre\u2010revision TKA, and post\u2010revision TKA. A multivariable linear regression analysis was performed to assess for effect modification on total ROM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient's pre\u2010revision mean flexion was 85.6 degrees, and mean extension was 10.1 degrees. At the time of the revision, the mean age of the cohort was 64.7 years, the average body mass index (BMI) was 29.8, and 62% were female. At a mean follow\u2010up of 4.5 years, revision TKA significantly improved terminal flexion by 18.4 degrees (<jats:italic>p\u2009&lt;\u2009<\/jats:italic>0.001), terminal extension by 6.8 degrees (<jats:italic>p\u2009=\u2009<\/jats:italic>0.007), and total arc of motion by 25.2 degrees (<jats:italic>p\u2009&lt;\u2009<\/jats:italic>0.001). The final ROM after revision TKA was not significantly different from the patient\u2019s pre\u2010primary TKA ROM (<jats:italic>p\u2009=\u2009<\/jats:italic>0.759). PROMIS physical function, depression, and pain interference scores were 39 (SD\u2009=\u20097.72), 49 (SD\u2009=\u20098.39), and 62 (SD\u2009=\u20097.25), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Revision TKA for arthrofibrosis significantly improved ROM at a mean follow\u2010up of 4.5 years with over 25 degrees of improvement in the total arc of motion, resulting in final ROM similar to pre\u2010primary TKA ROM. PROMIS physical function and pain scores showed moderate dysfunction, while depression scores were within normal limits. While physical therapy and MUA remain the gold standard for the early treatment of stiffness after TKA, revision TKA can improve ROM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-023-07353-8","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T16:45:16Z","timestamp":1676997916000},"page":"1859-1864","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Revision total knee arthroplasty for arthrofibrosis improves range of motion"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1181-3344","authenticated-orcid":false,"given":"Zachary A.","family":"Rockov","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cedars\u2010Sinai Medical Center 444 South San Vicente Boulevard, Suite 603 90048 Los Angeles CA 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I.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cedars\u2010Sinai Medical Center 444 South San Vicente Boulevard, Suite 603 90048 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy D.","family":"Paiement","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cedars\u2010Sinai Medical Center 444 South San Vicente Boulevard, Suite 603 90048 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad L.","family":"Penenberg","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cedars\u2010Sinai Medical Center 444 South San Vicente Boulevard, Suite 603 90048 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean S.","family":"Rajaee","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopaedic Surgery Cedars\u2010Sinai Medical Center 444 South San Vicente Boulevard, Suite 603 90048 Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/srep16469"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.01.072"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.04.011"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109290(83)90129\u2010X"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.02.005"},{"key":"e_1_2_11_7_2","unstructured":"CohenJS GuA KapaniN AsadourianPA StakeS QuanT MalahiasMA SculcoPKEfficacy of arthroscopic arthrolysis in the treatment of arthrofibrosis: a systematic review.J Knee 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