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J Knee Surg 2021; 34(12): 1349-1354
DOI: 10.1055/s-0040-1709182
Original Article

Efficacy of Arthroscopic Arthrolysis in the Treatment of Arthrofibrosis: A Systematic Review

Authors

  • Jordan S. Cohen

    1   Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia
    2   Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania

  • Alex Gu 

    1   Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia
    3   Department of Orthopaedic Surgery, The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York

  • Nisha Kapani

    1   Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia

  • Paul A. Asadourian

    4   Department of Orthopaedic Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, New York

  • Seth Stake

    1   Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia

  • Theodore Quan

    1   Department of Orthopedic Surgery, George Washington School of Medicine and Health Sciences, Washington, District of Columbia

  • Michael A. Malahias

    3   Department of Orthopaedic Surgery, The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York

  • Peter K. Sculco

    3   Department of Orthopaedic Surgery, The Stavros Niarchos Foundation Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, New York
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Abstract

Stiffness after total knee arthroplasty (TKA) remains a clinical challenge for health care professionals. Historically, arthroscopic arthrolysis is a treatment modality that has been reserved for patients that have failed other conservative modalities, including manipulation under anesthesia. However, a systematic review of the literature evaluating the clinical efficacy and complications of arthroscopic arthrolysis for stiffness after TKA has not been performed. A systematic review of medical databases (PubMed, EMBASE, Cochrane Library) was undertaken for articles published from January 1980 to October 2018. A descriptive and critical analysis of the results was performed. From 1,326 studies, 7 studies met the inclusion criteria for this study. A total of 160 patients who underwent arthroscopic arthrolysis for arthrofibrosis following TKA were included for analysis. The quality of the evidence for the included studies ranged between moderate and high. Overall, patients had significant increased range of motion and flexion by 32.5 and 26.7 degrees, respectively following arthroscopic arthrolysis. Functional outcome scores also significantly improved for patients who underwent arthroscopic arthrolysis after TKA. Arthroscopic arthrolysis is an efficacious modality for treatment of stiffness following TKA. The greatest benefit is seen among patients that present with significant loss of flexion. Arthroscopic arthrolysis should be reserved for patients that have previously failed more conservative modalities.

Keywords

stiffness - arthroscopic - total knee arthroplasty - arthrofibrosis

Note

The work was conducted at Hospital for Special Surgery, 535 E 70th St, New York NY 10021. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.




Publikationsverlauf

Eingereicht: 16. Oktober 2019

Angenommen: 16. Februar 2020

Artikel online veröffentlicht:
30. April 2020

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