Orthopedic Education Series - Stiffness in TKA: A Lecture for Residents & Fellows

Description

In this lecture, Adam Rosen discusses the increasing prevalence of total knee replacements and the associated complication of stiffness or arthrofibrosis. He emphasizes the importance of understanding preoperative range of motion and the factors that contribute to postoperative stiffness, including surgical technique and patient compliance with physical therapy. Rosen outlines his personal insights gathered from treating patients with severe stiffness post-surgery, explaining how he evaluates their condition through physical examination, operative reports, and imaging. He also reflects on the evolution of rehabilitation techniques and the debates surrounding continuous passive motion (CPM) devices, advocating for tailored physical therapy and the use of a structured follow-up schedule. Both patient education and setting clear expectations for recovery goals are highlighted as crucial for achieving optimal outcomes. Additionally, Rosen touches on various intervention strategies for managing stiffness, including manipulation under anesthesia and the role of arthroscopy, while stressing the need for careful assessment in determining the appropriate surgical approach. The lecture concludes with a call for further research into the biological basis of arthrofibrosis and the need for prevention strategies.

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