Abstract
Background
With the projected 673% increase in total knee arthroplasties (TKA) through the year 2030 in the United States alone, arthrofibrosis will become one of the more commonly encountered challenges in orthopaedic surgery.
Methods
After obtaining Institutional Review Board approval we retrospectively reviewed the results of 19 patients with a mean age at the time of surgery of 55.4 years (41–83) who underwent arthroscopic lysis of adhesions (ALOA) for arthrofibrosis at a minimum of 3 months after primary total knee arthroplasty by a single surgeon (SJC) at a single institution. All patients underwent a standardized adhesiolysis in the operating room. All patients had a minimum of 6 months follow up. All patients underwent arthroscopic lysis of adhersions for restricted range of motion (ROM) after failing aggressive physical therapy. We defined restriction in ROM as any extension lag >5°, and flexion ≤90°. Eight patients underwent manipulation under anesthesia for ROM less than 90° after ALOA.
Results
Preoperative ROM was compared to ROM measured at most recent follow up. The mean knee arc of motion improved by 17° (p=0.0402), the mean flexion arc improved from 17° (p=0.0263) and the number of patients with flexion less than or equal to 90° decreased from 13 patients to 6 patients (p=0.0049). There were no patients that required polyethylene exchange, no periprosthetic joint infections or intraoperative fractures and no patients who suffered deep vein thrombosis as a result of the procedure.
Conclusion
We conclude that arthroscopic lysis of adhesions for treatment of arthrofibrosis after total knee arthroplasty is a safe and effective way to improve post-operative range of motion.
