Manipulation under anesthesia (MUA) after total knee arthroplasty (TKA) frequently has been used as a first-line treatment to restore functional range of motion after unsuccessful physical therapy. Although there are studies reporting that MUA assisted in restoring range of motion, there is a paucity of literature on the influence of MUA on the risk of revision TKA. The goal of our study was to determine whether MUA was associated with an increase in the rate of revision TKA within 2 years of MUA. A total of 49,310 patients within a single institution who underwent primary TKA were identified from 1999 to 2019. Data were matched at a 1:3 ratio (TKA with and without MUA, respectively) based on age, sex, and body mass index. A matched comparison cohort was conducted, with the MUA cohort having 575 patients and the no MUA cohort having 1725 patients. A statistically significant increase in the rate of noninfectious etiology revision TKA was found in the MUA cohort (7.3%) compared with the no MUA cohort (4.9%; P=.034). The most common reason for revision TKA after MUA was persistent stiffness, including arthrofibrosis and ankylosis; however, aseptic loosening, ligamentous instability, and periprosthetic fracture were found to be responsible for 21.4% of revision TKA procedures. Although MUA is a commonly performed procedure for treating stiffness after primary TKA, the orthopedic surgeon should counsel patients on the association of increased rate of revision TKA after MUA, most commonly, persistent stiffness. [Orthopedics. 20XX;XX(X):xx–xx.]

全膝关节置换术 (TKA) 后的麻醉下操作 (MUA) 经常被用作在物理治疗不成功后恢复功能性运动范围的一线治疗。尽管有研究报道 MUA 有助于恢复运动范围，但关于 MUA 对翻修 TKA 风险的影响的文献很少。我们研究的目的是确定 MUA 是否与 MUA 后 2 年内 TKA 翻修率的增加有关。从 1999 年到 2019 年，在一个机构内共确定了 49,310 名接受原发性 TKA 的患者。根据年龄、性别和体重指数，数据以 1:3 的比例（分别为 TKA 加和不加 MUA）匹配。进行了匹配的比较队列，其中 MUA 队列有 575 名患者，无 MUA 队列有 1725 名患者。P =.034)。MUA 后进行 TKA 翻修的最常见原因是持续僵硬，包括关节纤维化和关节强直；然而，无菌性松动、韧带不稳和假体周围骨折被发现是造成 21.4% 翻修 TKA 手术的原因。虽然 MUA 是治疗初次 TKA 后僵硬的常用手术，但骨科医生应就 MUA 后 TKA 翻修率增加（最常见的是持续僵硬）向患者提供咨询。[骨科。20XX;XX(X):xx–xx.]