To investigate the clinical effect of manipulation under femoral nerve block analgesia in the treatment of stiffness after total knee arthroplasty.

During January 2013 to December 2017, 32 patients with stiffness after total knee arthroplasty were enrolled in this study. Ultrasound-guided continuous femoral nerve block were performed, followed by manipulation with passive knee flexion to the maximum extent, and functional rehabilitation exercises performed after manipulation. The knee flexion angle before and after manipulation, KSS scores and VAS scores during functional exercise were recorded.

Thirty-two patients were followed up for (20.4±3.1) weeks on average. The knee flexion angle was mean of (70.0±10.8)° before manipulation, the knee flexion angle was (106.4±7.9) ° on average at the last follow-up after manipulation under femoral nerve block analgesia(t=-28.5, P<0.05). The average improvement angle was (36.9±7.5)°. The average KSS score was (78.3±2.3) before manipulation, and was (88.3±2.7) at the last follow-up(t=-27.1, P<0.05). The VAS score during functional exercise was (4.5±1.1) on average, which was moderate pain. The patients were no periprosthetic fracture, extensor mechanism disruption or heterotopic ossification.

Manipulation was performed on patients with stiffness after knee arthroplasty under femoral nerve block analgesia can effectively improved knee function, and reduce the pain during manipulation.