Arthroscopic management of postoperative arthrofibrosis of the knee joint: indication, technique, and results.
From October 1987 through March 1991, 58 patients with postoperative joint stiffness underwent arthroscopic fibroarthrolysis. Forty-six knees in 46 patients were followed. The indication for arthroscopic management was decreased range of motion after surgery. Eighty-seven percent had been treated by arthrotomy. Thirteen percent had been managed by arthroscopic surgery. The indication for primary surgery was a torn anterior cruciate ligament in 74%. The mean interval between arthroscopic fibroarthrolysis and follow-up was 22.1 months. The average age was 32.7 years. A modified Blauth and Jäger score was used for classification of fibroarthrosis: grade I (mild 17.4%), grade II (moderate 63%), grade III (severe 15.2%), and grade IV (bad 4.3%). The gain in range of motion was evaluated by the Cauchoix index: the results were excellent in 54.5%, good in 21.7%, and fair and poor in 23.8%. Pain was evaluated according to a modification of the Lysholm score: 80.4% of the patients experienced a reduction in pain. The sports activity level in the Tegner activity scale increased from 2.3 to 4.8. Patient satisfaction was excellent or good in 56.5% (n = 26), fair in 39.1% (n = 18), and poor in 4.3% (n = 2). On the basis of our retrospective study, we feel that arthroscopic fibroarthrolysis is of benefit to the patients with postoperative joint stiffness even after a prolonged period.
Klein
W
W
Sangini Bone and Joint Clinic, Ellisbridge, Ahamedabad, India.
Shah
N
N
Gassen
A
A
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D007718:Knee Injuries / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D012421:Rupture; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative / Q000379:methods; D013997:Time Factors