Outcome of surgical treatment of arthrofibrosis following ligament reconstruction

Purpose Clinical outcome following surgical treatment and intensive physiotherapy was evaluated in patients with arthrofibrosis as a complication to varying knee-ligament reconstructions. Methods From 2003 to 2007, 31 patients underwent surgery for arthrofibrosis as a postoperative complication foll...

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Published in:	Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 19; no. 10; pp. 1704 - 1708
Main Authors:	Said, Sinan, Christainsen, Svend Erik, Faunoe, Peter, Lund, Bent, Lind, Martin
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer-Verlag 01-10-2011 Springer Nature B.V
Subjects:	Adolescent Adult Aged Arthroplasty Child Clinical outcomes Debridement Female Fibrosis Follow-Up Studies Humans Joint Diseases - etiology Joint Diseases - physiopathology Joint Diseases - surgery Knee Knee Joint - physiopathology Knee Joint - surgery Knees Ligaments Male Medicine Medicine & Public Health Middle Aged Orthopedics Pain Patients Physical therapy Postoperative Complications - physiopathology Postoperative Complications - surgery Range of motion Range of Motion, Articular Retrospective Studies Sports Surgery Trauma Treatment Outcome Young Adult Cyclops Ligament reconstruction Knee arthroscopy Arthrofibrosis
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Summary:	Purpose Clinical outcome following surgical treatment and intensive physiotherapy was evaluated in patients with arthrofibrosis as a complication to varying knee-ligament reconstructions. Methods From 2003 to 2007, 31 patients underwent surgery for arthrofibrosis as a postoperative complication following knee-ligament reconstruction. Treatment for reduced range of motion consisted of forced manipulation or arthroscopic arthrolysis followed by intensive physiotherapy. Twenty-seven patients (12 men and 15 women; median age 35(12–70) years) were followed up. Objective examination, Pain, KOOS and Tegner scores were used to evaluate the clinical outcome at follow-up. Results Fourteen patients were treated with forced manipulation alone, and the remaining thirteen were treated with forced manipulation and arthroscopic arthrolysis. The patients’ median follow-up was 51 months (19–73 months). Median interval between primary surgery and surgical release was 4 (1–32) months. Median range of motion (ROM) improved from −0°(0 to 20) to 0°(+2–9) in extension deficit and from 90°(40–145) to 130°(90–155) in flexion. Mean KOOS score were symptoms 63, pain 72, ADL 77, sport 42, QOL 45. Median Tegner score was 4 (2–9). Conclusion Surgical arthrolysis combined with intensive physiotherapy improved range of motion to nearly normal values. Subjective outcome scores revealed relatively poor outcome levels compared to uncomplicated knee-ligament reconstruction. Predictors of poor outcome were global arthrofibrosis and greater than 6-month time interval from primary reconstruction and surgical release. Level of evidence Retrospective clinical case series, Level IV.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 ObjectType-Feature-1
ISSN:	0942-2056 1433-7347
DOI:	10.1007/s00167-011-1472-6