title: Arthroscopic lysis of adhesions for stiff total knee arthroplasty.
abstract: The goal of this study was to evaluate the efficacy of arthroscopic lysis of adhesions after total knee arthroplasty (TKA) in improving range of motion (ROM) and providing an improvement in knee function. The authors retrospectively examined 19 patients who underwent arthroscopic lysis of adhesions following TKA due to poor ROM. The criterion for lysis was the inability to flex to 90° at 3 months. All patients were followed for at least 2 years after lysis. Patient demographics, postoperative and follow-up ROM,number of prior surgeries, Knee Society Scores, and Western Ontario and McMaster Universities Arthritis Index (WOMAC) functional scores were collected. Average ROM increased from 75.37° preoperatively to 98.95° postoperatively. The authors found an association between preoperative knee score and change in ROM between pre-arthroscopic lysis and ROM at final follow-up (P=.0188). When the authors examined the relationship between patient body mass index (BMI) and change in ROM,they found that patients with a BMI higher than 30 kg/m2 had a change of 26.44° compared with patients with a BMI lower than 30 kg/m2, who had a change of only 8.75°. A strong association was found between patient height and change in ROM and final ROM achieved (P=.0062 and .0032, respectively). The authors report a successful outcome among study patients. Furthermore, they found an association between patient height, BMI, and preoperative knee score and the improvement achieved after arthroscopic lysis of adhesions following TKA. The current study's results are comparable with those of published results. The authors recommend arthroscopic lysis of adhesions as a treatment option for stiff knees after TKA that fails after at least 3 months of nonoperative treatment.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
authors.forename: Arsani
authors.initials: A
authors.lastname: William
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Deering
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Fitz
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001182:Arthroscopy; D005260:Female; D005355:Fibrosis; D006801:Humans; D007719:Knee Joint / Q000473:pathology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery*