For the patient who has a total knee replacement, knee stiffness can be very disappointing and limiting. This type of stiffness is fairly common after a knee replacement.
What be done about it? Right now, there are two main options. She can try the conservative route with exercise and manual therapy under the supervision of a physical therapist. If that doesn’t work, then surgery is advised.
The surgeon must choose among three choices: 1) manipulation under anesthesia (MUA), 2) arthroscopic exam and debridement, and 3) open incision with revision. During manipulation under anesthesia, the patient is asleep while the surgeon moves the joint through its full range-of-motion. This forced movement breaks through areas of fibrosis and scar tissue. Debridement refers to gently scraping away any adhesions or fibrotic tissue that is keeping the joint “stuck” or unable to move beyond a certain point in the range of motion.
Arthroscopy allows the surgeon to see inside the joint and find out what’s holding it back from moving normally. Using a long, thin needle with a tiny TV camera on the end (the arthroscope, the surgeon can then correct the problem. If necessary, an improperly positioned implant can be removed and replaced using an open incision.
Your mother should return to her surgeon for a follow-up visit. The surgeon will examine her knee and determine the best approach for her particular problem. There may be several avenues open to her. Earlier treatment is often better than waiting too long as scar tissue and adhesions can continue to form further limiting her motion and function.