Exploring patients’ experiences and perceptions of manipulation under anesthesia for stiffness after total knee arthroplasty: a qualitative study

Purpose To gain in-depth insight into the experiences and perceptions of patients requiring manipulation under anesthesia (MUA) for persistent stiffness after total knee arthroplasty (TKA).Material and methods A pragmatic qualitative study using the interpretive description approach was used with reflexive thematic data analysis. Fifteen purposefully selected participants, with dysfunctional knee joint stiffness (flexion <90° and/or extension deficit ≥11°) requiring MUA, were interviewed. COREQ guidelines were followed.Results Six themes were developed: 1) Getting stuck, From limitation to stagnation: unexpected postoperative limitations with significant multifaceted impact; 2) MUA as a likely turning point, New beginning: for many participants; 3) Toward better recovery? Getting back on the bicycle, but not yet at the finish line: a demanding rehabilitation and presence of various limitations; 4) Emotional resilience, Coping with adversity and recovery: participants navigated uncertainty, fear, frustration, and dependence; 5) Support from and connection with healthcare providers and the environment, In trusted hands: support was pivotal; 6) Information and knowledge, Seeking clarity: clear information was lacking.Conclusions Persistent stiffness after TKA requiring MUA has a significant and multidimensional impact. MUA was often experienced as a turning point, while effective rehabilitation requires attention to biopsychosocial factors, clear information, and realistic expectations.