Stiffness After Total Knee Arthroplasty A Review.

Postoperative stiffness is a challenging problem in the setting of primary total knee arthroplasty. There remains a relatively high prevalence of patients suffering from this condition, and it can lead to unsatisfactory outcomes and need for revision surgery as well as a large financial burden on the health care system. There are a number of factors that predispose patients to developing arthrofibrosis, including patient-specific factors and intraoperative and postoperative considerations. Arthrofibrosis can be treated effectively in the early stages with manipulation under anesthesia with or without lysis of adhesions, however, those who fail to respond to these interventions may require revision surgery, which generally has poorer outcomes when performed for this indication. Current research is focused on understanding the pathologic cascade of arthrofibrosis and novel targeted therapeutics that may decrease stiffness in these patients and improve outcomes.