Manual Therapy according to Mulligan to Improve Knee Flexion in Patients after Total Knee Arthroplasty Randomised Controlled Trial

After implantation of total knee arthroplasty patients need to quickly develop adequate joint mobility in order to be able to cope with their daily activities. To date no evidence for the use of manual therapy techniques to support joint mobility in the rehabilitation phase after total knee arthroplasty has been published. The primary objective of this mono-centred randomised controlled trial was to examine the effect of the application of the manual therapeutic technique "mobilisation with movement" (MWM) according to the Mulligan Concept [1] [2] on knee flexion following primary total knee arthroplasty. Primary outcome measure was the mean value difference of active flexion. The secondary outcomes were the mean value difference of active extension, pain reduction and functional status. Regarding the primary outcome measure there was a statistically significant difference between the intervention and the control group. The secondary outcome pain reduction also showed a significant difference in favour of the intervention group. Further secondary outcome measures showed no significant differences. A statistically and clinically significant effect in favour of MWM techniques in comparison to rotatory mobilisation techniques was proven. In order to substantiate these effects further studies with higher sample sizes and follow-ups are necessary.