title: Perioperative rehabilitation using a knee extension device and arthroscopic debridement in the treatment of arthrofibrosis.
abstract: BACKGROUND
  Arthrofibrosis is a postoperative complication of intra-articular knee surgery that can be difficult to treat. Evidence suggests that maximizing knee range of motion may improve outcomes in patients with arthrofibrosis who undergo arthroscopic debridement.
  
  
  OBJECTIVE
  Patients who achieve greater knee range of motion will have better subjective scores.
  
  
  METHODS
  Retrospective case series analysis.
  
  
  METHODS
  A review of records was performed for 33 patients with arthrofibrosis who underwent knee arthroscopy and scar resection coupled with perioperative rehabilitation to maximize knee range of motion. Patient demographics and preoperative and postoperative range of motion measurements were extracted from the records. The International Knee Documentation Committee (IKDC) Subjective Knee Form was administered to assess pain, activity, and knee function. Patients performed a preoperative and postoperative rehabilitation program utilizing a knee extension device to maximize knee extension.
  
  
  RESULTS
  According to the IKDC range of motion criteria, 27 of 33 patients achieved normal knee extension, and 14 of 33 achieved normal knee flexion at a mean of 8.6 months after surgery. Patients with normal knee motion had a mean IKDC Subjective Knee Form score of 72.6 ± 13.6, which was significantly higher than patients who did not achieve normal motion (P = .04). Overall, mean IKDC Subjective Knee Form scores improved from 45.3 ± 16.7 preoperatively to 67.1 ± 18.0 postoperatively (P < .01) at a mean of 14.7 months after surgery.
  
  
  CONCLUSIONS
  Perioperative rehabilitation that emphasizes restoration of normal knee range of motion appears to improve outcomes in patients with arthrofibrosis who undergo arthroscopic scar resection. In support of our hypothesis, patients who achieved greater knee range of motion had better subjective knee scores.
authors.affiliation: Shelbourne Knee Center at Methodist Hospital, Indianapolis, Indiana.
authors.forename: Angie
authors.initials: A
authors.lastname: Biggs-Kinzer
authors.forename: Brian
authors.initials: B
authors.lastname: Murphy
authors.forename: K Donald
authors.initials: KD
authors.lastname: Shelbourne
authors.forename: Scott
authors.initials: S
authors.lastname: Urch