Arthroscopic Arthrolysis for Arthrofibrosis of the Knee after Total Knee Replacement


Alaa M. Hegazy, MD
The Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University

Mohamed A. Elsoufy, MD
The Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University

Abstract

Background 
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).

Methods
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.

Results
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.

Conclusions
Arthroscopic management can be beneficial for patients suffering from arthrofibrosis following total knee replacement. Pain and KSS clinical scores can markedly improve.

This article appears in HSS Journal: Volume 7, Number 2.
View the full article at springerlink.com.

About the HSS Journal
HSS Journal, an academic peer-reviewed journal, is published twice a year, February and September, and features articles by internal faculty and HSS alumni that present current research and clinical work in the field of musculoskeletal medicine performed at HSS, including research articles, surgical procedures, and case reports.


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