Arthroscopic Arthrolysis for Arthrofibrosis of the Knee after Total Knee Replacement
- 263 Downloads
Arthrofibrosis is an uncommon but potentially debilitating complication following total knee replacement which can result in chronic pain and poor recovery of range of motion. The treatment of this condition remains difficult and controversial.
Questions/aims of study
We reviewed our results of arthroscopic arthrolysis of arthrofibrosis of the knee after total knee replacement to assess the potential for this technique to improve range of motion and provide improvement in knee function and pain as measured by the Knee Society Score (KSS).
Eight patients were treated for arthrofibrosis after total knee replacement with arthroscopic management. The patients included five females and three males. The average age was 67.4 years. Initial rehabilitation efforts, which included manipulation under anesthesia, had failed. Arthroscopic arthrolysis was performed to release fibrous bands in the suprapatellar pouch and to reestablish the medial and lateral gutters. Lateral release of the patellar retinaculum was performed. Intensive physiotherapy and continuous passive motion began immediately post-operatively. The average follow-up was 37.4 months. The KSS was used for assessment of pain and function before arthroscopy and at the latest follow-up.
Six of the eight patients experienced improvement in the KSS. The average functional score showed improvement from 68 points pre-operatively to 86 at the time of final follow-up. The average pain scores improved from 30 points pre-operatively to 41 at the time of final follow-up.
Arthroscopic management can be beneficial for patients suffering from arthrofibrosis following total knee replacement. Pain and KSS clinical scores can markedly improve.
Keywordsarthrofibrosis total knee replacement arthroscopic management knee stiffness
- 2.Bocell JR, Thorpe CD, Tullos HS (1991) Arthroscopic treatment of symptomatic total knee arthroplasty. Clin Orthop 271:125–134.Google Scholar
- 7.Insall JN, Lawrence DD, Richard DS, and Norman S. Rationale of The Knee Society Clinical Rating System. Clin Orthop. 1989 Nov;(248):13–14.Google Scholar
- 12.Matthew R. Bong M, and Paul E. Di Cesare, MD. Stiffness after total knee arthroplasty Journal of American Academy of Orthopaedic Surgeons May/June 2004 2004;12(3):8.Google Scholar
- 18.Thorsten MS, David RM, Anil B, Johannes FP, German AM, Peter MB, Ronald ED and Michael AM . Arthroplasty Functional Problems and Arthrofibrosis Following Total Knee. J Bone Joint Surg Am. 2007;89:59–69.Google Scholar