Study presented at the 2013 Knee Society meeting in Chicago, IL, on March 23, 2013 analyzed residual stiffness at 6 months following knee replacement. The authors surveyed patients both preoperatively and at 6 months. They also surveyed the surgeons and recorded the expectations of the patient and the surgeon preoperatively. There were 246 patients studied in this survey. At 6 months, the perceived stiffness above what the patients expected was 40%. The impression of the surgeon at 6 months was often quite different from that of the patient. Of note, many patients complained of stiffness despite the fact that they also reported that they could bend and straighten their knee fully. This points to the fact that residual swelling and inflammation at 6 months can be interpreted by the patient as stiffness while the surgeon notes very good range of motion on the part of the patient. This underscores the need of patients and surgeons to talk honestly about the results after knee replacement. We as surgeons often equate full range of motion, i.e. 0 to 120+ degrees as a very good result while the patient may interpret that range of motion as satisfactory, but the knee still feels swollen and “stiff.” It generally takes up to 12+ months for the inflammation and swelling from the knee replacement to fully resolve and motion will continue to improve even after the 12-month followup.
—William P. Barrett, MD