Knee manipulation is a non-surgical intervention designed to improve mobility and reduce discomfort in certain knee conditions. It is often considered when conservative treatments, such as physical therapy, have not fully resolved stiffness or limited range of motion.
Understanding Knee Manipulation
Knee manipulation is a manual therapy technique performed by trained medical professionals to enhance joint motion and alleviate stiffness. Its primary goal is to break up scar tissue or adhesions that restrict movement and realign joint structures. These fibrous adhesions can limit the knee’s ability to move freely. The manipulation helps free these tissues, which can otherwise cause pain and hinder joint mobility.
When it is Considered
Knee manipulation may be considered for specific conditions when stiffness persists despite other treatments. A common indication is post-surgical stiffness, such as after a total knee arthroplasty (TKA), where scar tissue can limit the knee’s range of motion. It can also be an option for certain types of osteoarthritis that cause restricted movement or for conditions like adhesive capsulitis of the knee. This intervention is considered when a patient’s knee range of motion is limited, and physical therapy has not yielded sufficient improvement after several weeks.
What the Procedure Involves
Knee manipulation is often performed under anesthesia, which can be general or regional, allowing for muscle relaxation. During the procedure, the surgeon moves the knee through its range of motion with controlled force. These movements aim to break up fibrous adhesions and scar tissue within the joint. The entire procedure typically lasts only a few minutes, and patients are often discharged the same day.
Post-Procedure Expectations
Following knee manipulation, patients can expect some pain and swelling in the knee for a few days. Pain management is important during this initial period.
Immediate physical therapy is important to maintain the newly gained range of motion and prevent the reformation of scar tissue. Physical therapy exercises should begin as soon as the day of the procedure or within one to two days. Most patients experience increased knee mobility and improved pain control, although some residual pain and stiffness can persist. Full recovery typically takes between three to six months, depending on individual progress with physical therapy.
Important Considerations Beforehand
Before undergoing knee manipulation, a thorough medical evaluation by a specialist is necessary to determine suitability. Certain conditions may contraindicate the procedure, including:
Active infection
Severe osteoporosis
Certain fractures
Inflammatory arthritis
Acute inflammatory gout
Potential complications can occur. These may include continued stiffness, which is the most common complication, or fracture of the bone, nerve injury, or damage to the artificial knee implant. Alternatives to knee manipulation, such as intensive physical therapy or, in some cases, arthroscopic surgery to remove scar tissue, should be discussed with a healthcare provider.