Prevention and Treatment of Knee Arthrofibrosis

Noyes, Frank R.; Barber-Westin, Sue D.

doi:10.1016/b978-0-323-32903-3.00038-x

Cited by 10 publications

(4 citation statements)

References 176 publications

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“…Abnormal positioning of the patella is another pathology reported in patients with intraarticular adhesions (Noyes and Barber‐Westin 2017). The results of the current study suggest that adhesions in the suprapatellar pouch may lead to proximal translation of the patella, most prominently at 0 degrees of flexion.…”

Section: Discussionmentioning

confidence: 99%

Intraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics

et al. 2017

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Background: Arthrofibrosis in the suprapatellar pouch and anterior interval can develop after knee injury or surgery, resulting in anterior knee pain. These adhesions have not been biomechanically characterized. Methods: The biomechanical effects of adhesions in the suprapatellar pouch and anterior interval during simulated quadriceps muscle contraction from 0 to 90°of knee flexion were assessed. Adhesions of the suprapatellar pouch and anterior interval were hypothesized to alter the patellofemoral contact biomechanics and increase the patellofemoral contact force compared to no adhesions. Results: Across all flexion angles, suprapatellar adhesions increased the patellofemoral contact force compared to no adhesions by a mean of 80 N. Similarly, anterior interval adhesions increased the contact force by a mean of 36 N. Combined suprapatellar and anterior interval adhesions increased the mean patellofemoral contact force by 120 N. Suprapatellar adhesions resulted in a proximally translated patella from 0 to 60°, and anterior interval adhesions resulted in a distally translated patella at all flexion angles other than 15°(p < 0.05).

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Section: Discussionmentioning

confidence: 99%

Intraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics

et al. 2017

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“…This stretching protocol is similar to those used effectively by Noyes and Barber-Westin (2010) 35 and Davies and Ellenbecker (1999). 23 The STAK tool has a motivational scale which provides feedback for patients on their progress in gaining ROM (see Figure 2 ).…”

Section: Methodsmentioning

confidence: 89%

The STAK tool: evaluation of a new device to treat arthrofibrosis and poor range of movement following total knee arthroplasty and major knee surgery

et al. 2020

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Aims This study aims to evaluate a new home medical stretching device called the Self Treatment Assisted Knee (STAK) tool to treat knee arthrofibrosis. Methods 35 patients post-major knee surgery with arthrofibrosis and mean range of movement (ROM) of 68° were recruited. Both the STAK intervention and control group received standard physiotherapy for eight weeks, with the intervention group additionally using the STAK at home. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Oxford Knee Scores (OKS) were collected at all timepoints. An acceptability and home exercise questionnaire capturing adherence was recorded after each of the interventions. Results Compared to the control group, the STAK intervention group made significant gains in mean ROM (30° versus 8°, p < 0.0005), WOMAC (19 points versus 3, p < 0.0005), and OKS (8 points versus 3, p < 0.0005). The improvements in the STAK group were maintained at long-term follow-up. No patients suffered any complications relating to the STAK, and 96% of patients found the STAK tool ‘perfectly acceptable’. Conclusion The STAK tool is effective in increasing ROM and reducing pain and stiffness. Patients find it acceptable and adherence to treatment was high. This study indicates that the STAK tool would be of benefit in clinical practice and may offer a new, cost-effective treatment for arthrofibrosis. Cite this article: Bone Joint Open 2020;1-8:465–473.

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“…MUA is a treatment used in a wide array of situations, including knee arthrofibrosis, posttotal joint arthroplasty stiffness, and adhesive capsulitis. 33-35 For this patient, a short lever arm technique was done, as opposed to the long lever arm technique, which has been shown to have a higher rate of complications, which can include fracture and the need for revision surgery. 19 MUA for arthrofibrosis has been believed as a relatively benign, minimally invasive procedure to increase a patient's ROM, but here we show that there can be consequences for certain at-risk patients, and even potentially lead to limb loss.…”

Section: Discussionmentioning

confidence: 99%

Acute Femoropopliteal Bypass Graft Occlusion After Knee Manipulation Under Anesthesia: A Case Report and Review of Current Literature

2022

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Bilateral tibiofemoral knee dislocations are a relatively rare injury, and there is a scarcity of literature on its appropriate evaluation and treatment. Even less knee dislocations with concomitant popliteal artery injury have been described. Postoperative graft occlusion accounts for approximately half of the overall complication rate, occurring in up to 18% of the patients undergoing femoropopliteal bypass grafting. Furthermore, anticoagulation and antiplatelet therapy after graft placement is a point of contention. Here, we describe a case of a knee dislocation with associated popliteal artery transection treated initially with successful knee-spanning external fixation and arterial grafting, respectively. At 6 weeks after injury, the patient underwent external fixation removal and closed manipulation of the knee for arthrofibrosis. After manipulation, yet still under anesthesia, distal pulses were acutely diminished and subsequent CTA demonstrated femoropopliteal graft thrombosis. This case demonstrates successful recognition, thrombectomy, and restoration of arterial blood flow, which has since been maintained. Written consent by the patient involved in this case report was obtained.T ibiofemoral knee dislocations (KDs) are rare, so recognition and treatment of associated arterial injury can be difficult. [1][2][3][4] In addition, no gold standard for treating these concomitant orthopaedic and arterial injuries has been defined. 5 KDs are reported as less than 0.02% of all orthopaedic injuries. 6 Although there have been reported cases of bilateral KDs, there have been even fewer KDs with a concomitant popliteal artery injury. [1][2][3][4] In 2018, Moura et al 6 described a case of bilateral KDs with associated bilateral popliteal artery injuries, which was the first reported case at the time. A case series of two patients who required popliteal artery grafts after unilateral KDs reported limb survival; in their literature review, they found both a lower proportion of concomitant vascular injury with KDs and an even lower proportion that undergo surgical treatment than previously reported. 7 Zachary W. Fulton, DO

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Prevention and Treatment of Knee Arthrofibrosis

Cited by 10 publications

References 176 publications

Intraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics

Intraarticular arthrofibrosis of the knee alters patellofemoral contact biomechanics

The STAK tool: evaluation of a new device to treat arthrofibrosis and poor range of movement following total knee arthroplasty and major knee surgery

Acute Femoropopliteal Bypass Graft Occlusion After Knee Manipulation Under Anesthesia: A Case Report and Review of Current Literature

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