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Purpose <p>Postoperative stiffness is a common and incapacitating complication after total knee arthroplasty (TKA), significantly impacting functional outcomes. Open arthrolysis remains a less-studied surgical option. The objective of this study was to assess the use and outcomes of open arthrolysis in post-TKA stiffness management. We hypothesised that open arthrolysis is the least frequently used technique.</p> Methods <p>This was a retrospective multicentre study conducted as part of the 2024 SOFCOT symposium on post-TKA stiffness management, including 13 centres in France. Patients who underwent open arthrolysis for post-TKA stiffness between 2015 and 2019 were included. Demographic, radiographic, and clinical data were collected, and functional outcomes were evaluated using KOOS, Oxford, and JFS-12 scores preoperatively and postoperatively. Range of motion (ROM) was assessed and compared across different treatment modalities.</p> Results <p>Among 490 patients treated for post-TKA stiffness, 12 (2.4%) underwent open arthrolysis. The mean follow-up duration was seven&#xa0;years. Open arthrolysis patients were treated later than those undergoing manipulation under anaesthesia (28.1 vs. 7.2&#xa0;months, p = 0.001) and later than arthroscopic arthrolysis patients without statistical difference (9.9&#xa0;months, p = 0.216). Mean ROM improved by 27° postoperatively but remained lower than in other treatment groups (74° vs. 98°, <i>p</i> = 0.011). More than 90% of open arthrolysis patients reported dissatisfaction, compared to 26% for other techniques (<i>p</i> &lt; 0.001).</p> Conclusion <p>Open arthrolysis is rarely performed for post-TKA stiffness with higher patient dissatisfaction rates than other treatment modalities. These findings suggest that open arthrolysis may have a limited role in post-TKA stiffness management.</p>

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Open arthrolysis is rarely performed in the management of stiffness after total knee arthroplasty

  • 期刊论文

  • 发表日期：

    2026年2月2日

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  • Rémi Garrigue,
  • Renaud Siboni,
  • Grégoire Micicoi,
  • Ainu Verdini,
  • Cécile Batailler,
  • Bruno Miletic,
  • Matthieu Ehlinger

摘要

Purpose

Postoperative stiffness is a common and incapacitating complication after total knee arthroplasty (TKA), significantly impacting functional outcomes. Open arthrolysis remains a less-studied surgical option. The objective of this study was to assess the use and outcomes of open arthrolysis in post-TKA stiffness management. We hypothesised that open arthrolysis is the least frequently used technique.

Methods

This was a retrospective multicentre study conducted as part of the 2024 SOFCOT symposium on post-TKA stiffness management, including 13 centres in France. Patients who underwent open arthrolysis for post-TKA stiffness between 2015 and 2019 were included. Demographic, radiographic, and clinical data were collected, and functional outcomes were evaluated using KOOS, Oxford, and JFS-12 scores preoperatively and postoperatively. Range of motion (ROM) was assessed and compared across different treatment modalities.

Results

Among 490 patients treated for post-TKA stiffness, 12 (2.4%) underwent open arthrolysis. The mean follow-up duration was seven years. Open arthrolysis patients were treated later than those undergoing manipulation under anaesthesia (28.1 vs. 7.2 months, p = 0.001) and later than arthroscopic arthrolysis patients without statistical difference (9.9 months, p = 0.216). Mean ROM improved by 27° postoperatively but remained lower than in other treatment groups (74° vs. 98°, p = 0.011). More than 90% of open arthrolysis patients reported dissatisfaction, compared to 26% for other techniques (p < 0.001).

Conclusion

Open arthrolysis is rarely performed for post-TKA stiffness with higher patient dissatisfaction rates than other treatment modalities. These findings suggest that open arthrolysis may have a limited role in post-TKA stiffness management.