**7. Postoperative management**

A light pressure dressing is applied, and cryotherapy can be used to reduce swelling and knee pain. The effectiveness of rehabilitation on functional outcomes *Primary Total Arthroplasty in Stiff Knees DOI: http://dx.doi.org/10.5772/intechopen.106225*

**Figure 6.** *Postoperative radiography in anteroposterior view after TKA in stiff knee.*

depends on the appropriate timing, intensity, and progression of the ROM, accounting for the patient's ability and level of pain. The use of the removable knee orthosis is debatable. It can be used in static or dynamic manner in attempt to avoid loss of motion after TKA [27]. The patient is immediately placed in a continuous passive motion (CPM) machine from 0° to 30° of flexion in the recovery room. The flexion is increased 10° a day or as tolerated. The physical therapy can be prescribed in the early stage of the postoperative rehabilitation protocol intercalated with the CPM to optimize the gain of knee motion [28]. The pain control is crucial to achieve the progressive ROM. The use of spinal or epidural catheters with analgesic infusion can

**Figure 7.** *Postoperative radiography in lateral view after TKA in stiff knee.*

be helpful after TKA in SKNs. The early quadriceps activation is recommended with physical methods (sensory transcutaneous electrical stimulation), active isometric contraction, and early deambulation with walker or crutches. After TTO and V-Y quadricepsplasty, the rehabilitation protocol is delayed to preserve bone and soft tissue healing, mainly between 4 to 6 weeks. A long orthosis is recommended in the lower limb to keep the gait secure. The recovery of quadriceps function is essential to achieve a satisfactory outcome during the day life activities, improve ROM, and obtain a stable gait [29].
