Results of knee manipulations after anterior cruciate ligament reconstructions

We analyzed the results of knee manipulations in 42 knees that had persistent flexion or extension deficits after intraarticular ACL reconstructions. All manipula tions were done under a spinal or general anesthetic and, in 10 cases, arthroscopic debridement of adhe sions also was performed. The average time from re construction to manipulation was 7 months (range, 3 to 14 months) and the average followup was 26 months (range, 6 to 56 months). At manipulation, average flex ion was increased from 95° to 136° and average ex tension from 11° to 3°. In no case was motion gained at the expense of joint stability and, at final followup, average flexion and extension were 127° and 4°, re spectively. The final range of motion achieved was not affected by the time to manipulation, severity of pre manipulation flexion deficit, or concomitant arthro scopic debridement of adhesions. However, knees with premanipulation extension deficits of ≥15° achieved significantly less final extension than knees with lesser premanipulation deficits. Overall, manipulations were a safe and effective method for improving both flexion and extension in 86% of the knees that had restricted motion after ACL reconstructions.