{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:52:15Z","timestamp":1784116335882,"version":"3.55.0"},"reference-count":0,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose: Manipulation under anesthesia (MUA) is the first-choice treatment for stiffness following total knee arthroplasty (TKA) unresponsive to pain management and physiotherapy. Some of the predisposing factors and patient-reported outcome measures (PROMs) following MUA remain poorly studied. We retrospectively investigated the etiological risk factors and the outcomes of MUA.Patients and methods: 391 TKA patients from a randomized trial comparing the use of a tourniquet and anesthesia (spinal or general) were analyzed, and patients needing MUA were identified (MUA group). We evaluated in-hospital opioid consumption, Oxford Knee Score (OKS), range of motion (ROM), and pain assessed by the Brief Pain Inventory-short form with a 1-year follow-up.Results: 39 (10%) MUA patients were identified. The MUA patients were younger (60 years vs. 64 years, difference \u20134, 95% CI \u20136 to \u20131) and had higher postoperative oxycodone consumption (66 mg vs. 51 mg, median difference 11, CI 1\u201322) than the no-MUA patients. The proportion of MUA patients who contacted the emergency department within 3 months because of pain was larger than that of non-MUA patients (41% vs. 12%, OR 5, CI 3\u201310). At the 1-year follow-up, the ROM was improved by 39\u00b0 following MUA, but the total ROM was worse in the MUA group (115\u00b0 vs. 124\u00b0, p &lt; 0.001). No difference was found in the OKS between the MUA and no-MUA patients.Interpretation: Higher postoperative pain seems to predict MUA risk. MUA performed 3 months postoperatively offers substantial ROM improvement and comparable PROMs to no-MUA patients 1 year after TKA.<\/jats:p>","DOI":"10.2340\/17453674.2022.2272","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T07:38:12Z","timestamp":1649921892000},"page":"432-437","source":"Crossref","is-referenced-by-count":14,"title":["Postoperative pain as a risk factor for stiff knee following total knee arthroplasty and excellent patientreported outcomes after manipulation under anesthesia"],"prefix":"10.2340","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9688-209X","authenticated-orcid":false,"given":"Mikko T","family":"Rantasalo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6522-1272","authenticated-orcid":false,"given":"Riku A","family":"Palanne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhdev","family":"Saini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4708-1779","authenticated-orcid":false,"given":"Anne P","family":"Vakkuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rami","family":"Madanat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1470-4397","authenticated-orcid":false,"given":"Skants K","family":"Noora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2022,4,14]]},"container-title":["Acta Orthopaedica"],"original-title":[],"link":[{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/2272\/3680","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/2272\/3698","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/2272\/3697","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/actaorthop.org\/actao\/article\/download\/2272\/3680","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T01:53:43Z","timestamp":1734573223000},"score":1,"resource":{"primary":{"URL":"https:\/\/actaorthop.org\/actao\/article\/view\/2272"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,14]]},"references-count":0,"URL":"https:\/\/doi.org\/10.2340\/17453674.2022.2272","relation":{},"ISSN":["1745-3682","1745-3674"],"issn-type":[{"value":"1745-3682","type":"electronic"},{"value":"1745-3674","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4,14]]}}}