A Comprehensive Approach to Stiffness in Total Knee Arthroplasty.

Knee stiffness is a common complication after total knee arthroplasty with significant clinical consequences because limited range of motion negatively affects joint function and is associated with pain and disability. The prevention of stiffness is a goal in the perioperative setting, with the plan to optimize and modify risk factors whenever possible. Once stiffness develops, early identification and treatment may positively affect patient outcome. For persistent stiffness, additional surgical intervention may be required. It is important to present an overview of the pathophysiology of arthrofibrosis, the preoperative and perioperative risk factors for the development of arthrofibrosis and how to optimize patients to reduce this risk, and treatment options for stiffness in both the early and late postoperative periods.