gms | German Medical Science

Objectives: The development of chronic pain and stiffness in patients knee operated are frustrating circumstances for patient and surgeon. Arthrofibrosis is a relatively common complications and very disabling for daily living, which should be prevented and treated properly.

Our study analyzes the clinical improvement obtained with arthroscopic arthrolysis performed in patients with secondary arthrofibrosis to osteosynthesis of fractures, ACL plasty, dislocations or knee replacements.

Methods: Twenty-six patients, fifteen women and eleven men with secondary arthrofibrosis persistent knee after the initial rehabilitation, were treated by arthroscopic arthrolysis to release articular fibrosis generated. In all the subsequent immobilization with early rehabilitation (average duration 4 months) and immediate loading it was avoided.

Functional outcomes such as the extent and final flexion range of motion, Lisholm test, residual pain and postoperative complications occurred were evaluated.

Results and Conclusion: After at least 12 months postoperatively, the extension obtained in all patients was 0°, with 120° of flexion average. Lisholm test yielded a mean score of 67 (45 - 91.5), improving all patients by an average of 43.5 points (23.5 - 57.65). The range of movement also improved postoperatively in 37.5 ° (20-50) on average and the average postoperative pain according to VAS was 2 (0-4).

Complications were presented hemarthros of repetition with limited mobility, intolerance to prior osteosynthesis material and decreased range of motion.

The bivariate analysis of our clinical variables showed statistically significant association between increased knee flexion after arthrolysis in patients who previously had not been immobilized (p = 0.021); and increased range of motion (p = 0.025) and the score on the test Lisholm (p = 0.025) in patients with early loading after the initial injury.The arthroscopic arthrolysis is beneficial for the treatment of knee arthrofibrosis. Variables such as range of motion, Lisholm test showed a marked improvement, being more evident in patients with previous ACL plasty that had been immobilized.