During a twelve-month period, 23 per cent of a series of knees
undergoing total replacement were manipulated two weeks postoperatively to
increase flexion. While manipulation achieved an immediate increase in
flexion from a mean of 71 degrees to a mean of 108 degree, by one week
after manipulation the mean flexion was reduced to 88 degrees. By one year
postoperatively, the manipulated knees were found to have a range of motion
similar to that of their non-manipulated counterparts. Such factors as
preoperative flexion and diagnosis appear to be the major determinants of
ultimate flexion, and they seem to offset the temporarily increased flexion
afforded by manipulation. The primary reason for manipulation is to
facilitate the postoperative rehabilitation program for patients with
painful, limited motion of the knee.