This 2004 narrative review by Bong and Di Cesare systematically evaluates postoperative stiffness after TKA — its true incidence, the preoperative, intraoperative, and postoperative factors that drive it, and a time-based algorithm for when and how to intervene.
When a post-TKA patient is stiffening before 3 months and components are well-positioned, move quickly to manipulation — the window closes fast and late manipulation underperforms by nearly 7° of final flexion.
When stiffness appears after a patient who had initially done well, treat it as a diagnostic problem first: rule out infection (ESR, CRP, aspiration), loosening, and CRPS before committing to lysis or revision.
This 2004 narrative review by Bong and Di Cesare systematically evaluates postoperative stiffness after TKA — its true incidence, the preoperative, intraoperative, and postoperative factors that drive it, and a time-based algorithm for when and how to intervene.
When a post-TKA patient is stiffening before 3 months and components are well-positioned, move quickly to manipulation — the window closes fast and late manipulation underperforms by nearly 7° of final flexion.
When stiffness appears after a patient who had initially done well, treat it as a diagnostic problem first: rule out infection (ESR, CRP, aspiration), loosening, and CRPS before committing to lysis or revision.