title: Low-dose irradiation and constrained revision for severe, idiopathic, arthrofibrosis following total knee arthroplasty.
abstract: Treatment options for arthrofibrosis following total knee arthroplasty include manipulation under anesthesia, open or arthroscopic arthrolysis, and revision surgery to correct identifiable problems. We propose preoperative low-dose irradiation and Constrained Condylar or Rotating-hinge revision for severe, idiopathic arthrofibrosis. Irradiation may decrease fibro-osseous proliferation while constrained implants allow femoral shortening and release of contracted collateral ligaments. Fourteen patients underwent fifteen procedures for a mean overall motion of 46° and flexion contracture of 30°. One patient had worsening range of motion while thirteen patients had 57° mean gain in range of motion (range 5°-90°). Flexion contractures decreased by a mean of 28°. There were no significant complications at a mean follow up of 34 months (range 24 to 74 months).
authors.affiliation: University of Illinois at Chicago, Illinois, USA.
authors.forename: Yasser R
authors.initials: YR
authors.lastname: Farid
authors.forename: Rishi
authors.initials: R
authors.lastname: Thakral
authors.forename: Henry A
authors.initials: HA
authors.lastname: Finn
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D049109:Cell Proliferation / Q000528:radiation effects; D005260:Female; D005269:Femur / Q000601:surgery*; D005347:Fibroblasts / Q000473:pathology / Q000528:radiation effects; D005355:Fibrosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007592:Joint Diseases / Q000473:pathology / Q000628:therapy*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D007720:Knee Prosthesis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011878:Radiotherapy / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: arthrofibrosis; constrained condylar; irradiation; revision; rotating-hinge