Etiology and Surgical Interventions for Stiff Total Knee Replacements

HSS Journal

Alejandro González Della Valle, MD (en Español)
Alejandro González Della Valle, MD (en Español)

Cirujano Ortopédico, Hospital for Special Surgery
Profesor Asociado de Cirugía Ortopédica, Weill Cornell Medical College

Steven B. Haas, MD
Steven B. Haas, MD
Chief of Knee Service, Hospital for Special Surgery
Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor, Weill Cornell Medical College

Alejandro Leali, MD
Department of Orthopaedic Surgery, Hospital for Special Surgery

Stiffness is the most prevalent early local complication of primary total knee replacement, affecting approximately 6 to 7% of patients undergoing surgery. The definition of stiffness after total knee replacement in terms of restriction of the arc of motion has evolved in the last decade as patients and physicians expect better postoperative functional outcomes. Gentle manipulation under anesthesia within 3 to 4 months of surgery improves the range of motion in most patients. However, approximately 1% of patients, including those in which the window for manipulation has passed, will require further surgical interventions which may include arthroscopy with lysis of adhesions, open debridement with exchange of the polyethylene insert, or revision of one or more components. This review will focus on describing the etiology of the problem and the results of the different surgical interventions for stiffness following total knee replacement.

This article appears in HSS Journal: Volume 3, Number 2.
View the full article at

About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.

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