MUA to Treat Postoperative Stiffness After Total Knee Arthroplasty



Status:Recruiting
Healthy:No
Age Range:18 - 90
Updated:10/20/2018
Start Date:April 2016
End Date:February 2021
Contact:Jennifer Krogman
Email:krogman.jennifer@mayo.edu
Phone:(507) 538-3562

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Manipulation Under Anesthesia (MUA) to Treat Postoperative Stiffness After Total Knee Arthroplasty: A Multicenter Randomized Clinical Trial

Compare the outcome following manipulation under anesthesia for stiffness in a randomized
controlled fashion with one group receiving IV dexamethasone and oral celecoxib at the time
of manipulation to a control group receiving manipulation alone.

Outcomes will include pain, range of motion, as well as subjective outcome scores.

Stiffness is a potential complication following Total Knee Arthroplasty (TKA). While a
variety of factors have been cited as possible causes, such as component malrotation or
improper soft-tissue balancing, however, an etiology is not always appreciated. Histologic
and arthroscopic evidence of fibrosis suggests that an inflammatory process may contribute to
loss of knee range of motion following surgery. Manipulation under anesthesia remains
standard of care for stiffness following TKA. Manipulation shows improved range of motion for
stiffness after total knee arthroplasty, however, patients do not always achieve full range
of motion. Furthermore, repeat manipulation and manipulation greater than 8 weeks
post-surgically have shown limited improvements. Given a possible role of the host
inflammatory response and the importance of early gains in knee range of motion following
total knee arthroplasty, limiting the inflammatory response at the time of manipulation may
improve outcomes. Investigators would like to assess the role of anti-inflammatory
medications to optimize range of motion and outcome for manipulation under anesthesia for
stiffness following TKA.

Inclusion Criteria:

1. Subjects who have received a primary unilateral TKA for a diagnosis of osteoarthritis.

2. MUA's scheduled between 6-10 weeks postoperatively

Exclusion Criteria:

1. Intolerance to NSAIDs

2. Renal dysfunction

3. Age < 18 or > 90 years

4. Primary diagnosis of rheumatoid arthritis

5. Patients with a Glomerular Filtration Rate (GFR) <60 as the cut off for Chronic Kidney
Disease (CKD) (stage 3 CKD)
We found this trial at
16
sites
Denver, Colorado 80210
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9500 Euclid Avenue
Cleveland, Ohio 44106
216.444.2200
Cleveland Clinic Cleveland Clinic is committed to principles as presented in the United Nations Global...
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Charlotte, North Carolina 28207
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1653 W. Congress Parkway
Chicago, Illinois 60612
(312) 942-5000
Rush University Medical Center Rush University Medical Center encompasses a 664-bed hospital serving adults and...
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Durham, NC
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Houston, Texas 77030
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1200 Manor Drive
Lansdale, Pennsylvania 19446
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1701 Aldersgate Road
Little Rock, Arkansas 72205
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New Albany, Ohio 43054
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New York, New York
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535 E 70th St
New York, New York 10021
(212) 606-1000
Hospital for Special Surgery Founded in 1863, Hospital for Special Surgery is the nation
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622 West 168th Street
New York, New York 10032
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Emile St
Omaha, Nebraska 68198
(402) 559-4000
Univ of Nebraska Med Ctr A vital enterprise in the nation’s heartland, the University of...
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601 Walnut Street
Philadelphia, Pennsylvania 19106
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Philadelphia, PA
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Rochester, Minnesota 55905
Principal Investigator: Matthew Abdel, M.D.
Phone: 507-538-3562
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Salt Lake City, Utah 84108
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