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.

Predictors of Knee Arthrofibrosis and Outcomes after Arthroscopic Lysis of Adhesions following Ligamentous Reconstruction: A Retrospective Case–Control Study with Over Two Years' Average Follow-Up

“…Other studies have reported improvements in knee scores following LOA for the stiff total knee arthroplasty. 28,29 Despite these findings, no previous study has examined improvements in functional knee scores following LOA in the stiff knee after ligamentous reconstruction.…”

Efficacy of Arthroscopic Arthrolysis in the Treatment of Arthrofibrosis: A Systematic Review

“…9 The remaining studies found suitable for inclusion were scored on a scale of 0 to 100 based on 11 different standards from the CMS. [10][11][12][13][14][15][16]…”

“…[11][12][13][14]16 Following arthroscopic arthrolysis, the mean final follow-up time from all included studies was 24.8 months (range 1-124 months; ►Table 5). [10][11][12][13][14][15][16]…”

Treatment of post-traumatic joint contracture in a rabbit model using pulsed, high intensity laser and ultrasound

“…Post-traumatic contracture can result from either an initial injury to the joint or as a complication from surgery on the joint, such as anterior cruciate ligament (ACL) reconstruction or total knee arthroscopy (TKA) (Cosgarea et al, 1994). Currently when patients have joint contracture due to arthrofibrosis they will receive either conservative treatment or in more severe cases, surgery to release the contracture, however a complete recovery is not always attained (Enad, 2014, Hutchinson et al, 2005, Schiavone Panni et al, 2009, Schwarzkopf et al, 2013, Kucera et al, 2007, Cosgarea et al, 1994.…”