A total knee arthroplasty (TKA) may be performed on patients who have osteoarthritis of the knee. However, some patients may not regain full range of motion of the knee after surgery. For these people, surgical manipulation of the knee may be required to restore motion to the knee.
Surgical manipulation of the knee after surgery is done under general anesthesia or with an epidural. The patient is usually positioned on his back, and an assistant holds the heel while passive extension is performed by the surgeon. The knee is then flexed until the knee moves more freely.
The function of a surgical knee manipulation following a TKA is to tear away scar tissue that has formed in the joint as a result of the surgery. The surgeon repeats the flexion and extension movements until the knee moves more easily.
Most surgeons take an x-ray of the knee joint to ensure the hardware from the TKA is still in position. Ice is applied and inpatient physical therapy is usually performed following a knee manipulation. Physical therapy may be prescribed upon discharge from the hospital to ensure the patient regains normal range of motion.
A patient who has not achieved at least 100 degrees of flexion (bending) by four to eight weeks following surgery may be a candidate for surgical manipulation. Surgical manipulation is not generally recommended until the patient undergoes physical therapy and other means of achieving normal range of motion.
Surgical knee manipulation after TKA is generally safe and can help the patient regain more range of motion of the knee. This can be helpful in performing the activities of daily living such as rising from a chair and walking.