The Stiff Total Knee Arthroplasty: A Contemporary Approach

Stiffness after total knee arthroplasty (TKA) is uncommon but not rare. Estimates of the prevalence of stiffness vary according to the definition but range from 1 to 12%. For surgeons a stiff TKA is a frustrating problem because the precise cause of stiffness remains poorly understood in the vast majority of cases. When revision TKA is performed without identifying the cause of stiffness, only modest improvements after revision can be expected. In a select subgroup of patients, however, a clear etiology for stiffness can be identified. The results of surgical intervention in that subgroup of patients with a clear etiology for stiffness are substantially more predictable. Our contemporary approach to stiffness after TKA focuses on identifying extrinsic causes, intrinsic causes, or patient-related causes for the stiffness.