Impact of Manipulation Under Anesthesia on Functional Outcomes Following Total Knee Arthroplasty: A Systematic Review of the Knee Society Score (KSS), Oxford Knee Score (OKS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

Cureus 2026 Open access

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Authors: Salis Aizaz Rasool, Mashal Mumtaz, Muhammad Zain Ul Abidin, Abdalla Kandeel, Shashwat Shetty, Rana Ahmed, Soliu Hamed Opeyemi, Shenouda R Shehata Abdelmesih, Ayan Ali
DOI: 10.7759/cureus.106845
Cited by: 1
References: 13

Abstract

Postoperative stiffness remains a significant complication following total knee arthroplasty (TKA), affecting functional recovery and patient satisfaction. Manipulation under anesthesia (MUA) is commonly employed when conservative measures fail, yet the impact on patient-reported outcomes remains unclear. This systematic review evaluated functional outcomes following MUA, focusing on the Knee Society Score (KSS), Oxford Knee Score (OKS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was conducted up to February 1, 2026, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Six studies, including retrospective and prospective cohorts and a systematic review, were included. Early MUA (

Fields of Study & Subjects

Total Knee Arthroplasty Outcomes Osteoarthritis Treatment and Mechanisms Anesthesia and Pain Management

Publication details

Journal / source
Cureus
Publisher
Springer Science and Business Media LLC
Volume
18
Issue
4
Pages
e106845–e106845
Publication date
11 April 2026
Language
EN