Etiopathology and Management of Stiff Knees: A Current Concept Review

Abstract

Background: Knee stiffness after trauma, fracture fixation, arthroscopic surgery, infection, and knee arthroplasty is a known complication, which is challenging to manage and causes significant disability to the patients.

Methods: We did a comprehensive search on the stiff knees, in the last week of May 2020, from the search engines of PubMed, SCOPUS, Google Scholar, and Research Gates using the appropriate keywords.

Results: We found two types of articles related to knees stiffness: (a) following trauma, internal and external fixation of fractures and arthroscopic surgery, and (b) following total knee arthroplasty. Arthroscopic surgery was found to be a favored mode of management of stiff knees in both of the above groups. The Manipulation under Anesthesia (MUA) was also found effective if done carefully and in the early course of the stiffness.

Conclusion: Knee stiffness due to any cause is a trouble proposition to both patients and treating surgeons. Various methods of management have been described to deal with knee stiffness. Amongst the operative treatment, MUA and arthroscopic surgery were found to be the most effective. Arthroscopic surgery offers a good option of release stiff knees in the majority of cases, and it is most valuable and effective if done earlier in the course of the stiffness (preferably between 3 and 6 months).

Keywords: Ankylosis; Arthrolysis; Arthroplasty; Arthroscopy; Injuries; Stiff knees.