Arthrofibrosis of the Knee

Magit, David P.; Wolff, Ändy; Sutton, Karen M.; Medvecky, Michael J.

doi:10.5435/00124635-200711000-00007

Cited by 198 publications

(170 citation statements)

References 48 publications

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“…We advocate simultaneous reconstruction of the 2 structures because both are integral structures in maintaining the stability of the knee 1,2,14,15 ; if one of them fails to recover its function and the other has to replace this function, this may result in the second structure incurring excess tension and leading to surgical failure. Many scholars tend to advocate staged surgery because they are worried about motion loss after knee surgery 28,29 : When one is assessing the benefits of either operating NOTE. Data are presented as mean AE standard deviation unless otherwise indicated.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Acute Grade III Medial Collateral Ligament Injury Combined With Anterior Cruciate Ligament Injury: Anatomic Ligament Repair Versus Triangular Ligament Reconstruction

Dong

Wang

Men

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Acute Grade III Medial Collateral Ligament Injury Combined With Anterior Cruciate Ligament Injury: Anatomic Ligament Repair Versus Triangular Ligament Reconstruction

Dong

Wang

Men

et al. 2015

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…While some studies have reported that the condition does not improve postoperatively [17][18][19][20], other investigators have shown gradual recovery with conservative management [19,[21][22][23][24]. It has been well established that the presence of a preoperative flexion contracture increases the risk of developing a postoperative flexion contracture [5].…”

Section: Discussionmentioning

confidence: 99%

The natural history of a newly developed flexion contracture following primary total knee arthroplasty

Anania¹,

Abdel

Lee

et al. 2013

International Orthopaedics (SICOT)

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Purpose We investigated the incidence, natural history, and functional consequences of a newly developed flexion contracture after total knee arthroplasty (TKA). Methods Forty patients with full knee extension preoperatively who developed a postoperative flexion contracture were match-paired 1:2 with 80 patients who had full extension. The incidence of a newly developed flexion contracture, ROM, and Knee Society scores (KSS) at six weeks, four months, and one year were analysed. Results The incidence of a new flexion contracture at sixweeks was 14 %, but diminished to 5 % and 0.3 % at fourmonths and one year, respectively. One year after surgery, there was no difference in the KSS (p=0.5). Conclusions This study showed that the majority of patients who developed a new flexion contracture after TKA have full knee extension one year postoperatively. Moreover, knee extension and KSS at one year are equivalent to those patients who did not developed a flexion contracture.

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“…In 1 study, the average time from index procedure to manipulation was 7 months, and there was no clinically significant difference between patient groups treated < 6 months, or > 6 months after the ACL reconstruction. 37 The authors' preference is to consider proceeding with arthroscopy and manipulation within 3 to 4 months after the ACL procedure.…”

Section: Arthroscopymentioning

confidence: 99%

Knee Stiffness After ACL Reconstruction

Nauth¹,

Gilbart²

2012

Techniques in Knee Surgery

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Postoperative knee stiffness after anterior cruciate ligament reconstruction surgery is a significant clinical problem. Clinical deficits of knee flexion more than 10 degrees can limit function and athletic performance, and extension deficits of more than 5 degrees can cause gait changes and altered knee kinematics. The incidence reported in the literature varies significantly. Risk factors for the development of this condition include technical factors, graft selection issues, the timing of surgery relative to the traumatic injury, the presence of associated injuries, and postoperative rehabilitation. This chapter will review the incidence, risk factors, pathology, prevention, treatment options, and the clinical results of management of this condition.Key Words: anterior cruciate ligament reconstruction, single-bundle anatomic ACL reconstruction, knee stiffness, arthrofibrosis of the knee, physical therapy (Tech Knee Surg 2012;11: 26-33) K nee stiffness continues to represent one of the most common complications after anterior cruciate ligament (ACL) reconstruction surgery. This complication is of particular importance as stiffness after ACL reconstruction results in inferior functional outcomes and a higher incidence of radiographic evidence of arthritis. Knee stiffness presents as loss of motion and can include loss of extension, loss of flexion, or both. Normal knee range of motion (ROM) is from 5 degrees of hyperextension to 140 degrees of flexion. Deficits of > 10 degrees of flexion can limit athletic performance. Extension loss is poorly tolerated, with deficits of 5 degrees or greater producing gait changes, altering quadriceps function, and leading to patellofemoral arthritis. Prevention of knee stiffness after ACL surgery remains essential and requires a thorough understanding of the potential causes of loss of motion in ACL reconstruction. The treatment of loss of motion after ACL reconstruction requires an understanding of these causes and the pathoanatomy of the stiff knee. In addition, a systematic approach toward treatment of specific anatomic structures associated with the different types of motion loss is required for effective management. This article reviews the incidence, classification, risk factors, pathoanatomy, prevention, and treatment of knee stiffness after ACL reconstruction. EPIDEMIOLOGYThe true incidence of knee stiffness after ACL reconstruction is difficult to estimate as different studies have used different criteria for loss of motion and estimates have ranged from 2% 1 to 35%. 2 In a recent publication, Paxton et al 3 reported on one of the largest series of ACL reconstructions to date. In their prospective series of 4025 primary ACL reconstructions, the authors reported an overall reoperation rate of 4.4%. Knee stiffness was the second most common cause for reoperation (18.9% of reoperations) after meniscal/chondral injury (34.3% of reoperations), confirming that stiffness is one of the most common complications after ACL reconstruction.Stiffness of the knee after ACL recons...

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Arthrofibrosis of the Knee

Cited by 198 publications

References 48 publications

Surgical Treatment of Acute Grade III Medial Collateral Ligament Injury Combined With Anterior Cruciate Ligament Injury: Anatomic Ligament Repair Versus Triangular Ligament Reconstruction

Surgical Treatment of Acute Grade III Medial Collateral Ligament Injury Combined With Anterior Cruciate Ligament Injury: Anatomic Ligament Repair Versus Triangular Ligament Reconstruction

The natural history of a newly developed flexion contracture following primary total knee arthroplasty

Knee Stiffness After ACL Reconstruction

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