Outcomes of Manipulation Under Anesthesia Versus Surgical Management of Combat-Related Arthrofibrosis of the Knee


The purpose of this study was to compare the outcomes of manipulation under anesthesia (MUA) to arthrolysis for combat-related arthrofibrosis. Sixty-one knees in 56 patients who underwent treatment for arthrofibrosis secondary to lower extremity trauma were reviewed. Knee range of motion preoperatively, postoperatively, and at follow-up was analyzed. The primary outcome measure was the difference in knee arc of motion between the two cohorts. Forty-one knees (67.2%) underwent MUA and 20 knees (32.8%) were managed operatively. There was no difference in the preoperative arc of motion. Knees that underwent MUA had significant improvements in arc of motion compared to knees that underwent arthrolysis (106.3° vs. 82.3°) at a follow-up of 2 years (p D .008). The complication rate was greater in knees that underwent arthrolysis (40%) compared to knees that underwent MUA (12.2%; p D .04). In conclusion, knees that underwent MUA demonstrated significant improvements in arc of motion at 2-year follow-up with fewer complications. (Journal of Surgical Orthopaedic Advances 22(1):36–41, 2013)

Korboi N. Evans, MD, MS; Louis Lewandowski, MD; Adam Pickett, MD; Joseph E.
Strauss, DO; and Wade T. Gordon, MD