The stiff knee: Causes and cures

Gender, race, age, BMI, and pre-operative motion have been correlated with post-operative motion after TKA. Surgical techniques to achieve full motion include appropriate sizing and positioning of the implants, proper gap balancing and soft tissue release, removal of posterior condylar osteophytes, and adequate tibial slope. Patient education, pain management, and participation in post-operative rehabilitation are also important. If adequate motion is not achieved, then manipulation can be helpful particularly up to 3 months after surgery. Once scar tissue is more mature, 6 months to a year after surgery, arthroscopy to resect arthrofibrotic scar is an appropriate option. For stiffness beyond 1 year after surgery revision, TKA can be expected to result in modest improvement in motion, but pain relief may be quite variable.