A New Treatment Strategy for Severe Arthrofibrosis of the Knee

Jian-Hua Wang; Jin-Zhong Zhao; Yao-Hua He
March 2007
Journal of Bone & Joint Surgery, American Volume;Mar2007 Supplement, Vol. 89-A, p93
Academic Journal
BACKGROUND: To reduce the morbidity of traditional quadricepsplasty for the treatment of severe arthrofibrosis of the knee, we instituted a treatment regimen consisting of an initial extra-articular mini-invasive quadricepsplasty and subsequent intra-articular arthroscopic lysis of adhesions during the same anesthesia session. The purpose of the present study was to determine the results of this technique. METHODS: From 1998 to 2001, twenty-two patients with severely arthrofibrotic knees were managed with this operative technique. The mean age of the patients at the time of the operation was thirty-seven years. After a mean duration of follow-up of forty-four months (minimum, twenty-four months), all patients were evaluated according to the criteria of Judet and The Hospital for Special Surgery knee-rating system. RESULTS: The average maximum degree of flexion increased from 27° pre- operatively to 115° at the time of the most recent follow-up (p < 0.001). According to the criteria of Judet, the result was excellent for sixteen knees, good for five, and fair for one. The aver- age Hospital for Special Surgery knee score improved from 74 points preoperatively to 94 points at the time of the most recent follow-up (p < 0.001). A superficial wound infection occurred in one patient. Only one patient had a persistent 15° extension lag. CONCLUSIONS: This mini-invasive operation for the severely arthrofibrotic knee can be used to increase the range of motion and enhance functional outcome.


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