Comparison of minimally invasive arthrolysis vs. conventional arthrolysis for post-traumatic knee stiffness

Wu, Xing; Sun, Lei; Sun, Liang; Liu, Changcheng; Kong, Zhigang; Cui, Jian; Zhang, Zhiguo

doi:10.1016/j.jos.2017.09.021

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…The qualitative data were presented as frequencies or percentages and compared by the Chi-square test. According to Judet’s criteria (excellent: > 100°; good: 80° ~ 100°; fair: 50° ~ 80°; poor: < 50°), the curative effect was calculated using the following formula: excellent and good rate = [n (excellent) + n (good)]/n [ 21 ]. P < 0.05 was considered statistically significant for all analyses.…”

Section: Methodsmentioning

confidence: 99%

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

You

Yao

et al. 2023

BMC Musculoskelet Disord

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Background Knee arthroscopic arthrolysis serves as an effective treatment for knee arthrofibrosis. However, hemarthrosis is the most common complication in arthroscopic surgery, which has potential adverse effects on postoperative rehabilitation. The purpose of this study was to evaluate the effects of topical tranexamic acid (TXA) in knee arthroscopic arthrolysis. Methods A total of 87 patients with knee arthrofibrosis who underwent arthroscopic arthrolysis from September 2019 to June 2021 were eligible for this retrospective review. Patients in the TXA group (n = 47) received topical administration of TXA (50 mL, 10 mg/mL) at the end of the surgery, and patients in the control group (n = 40) received no TXA. The postoperative drainage volumes, hematologic levels, inflammatory marker levels, knee range of motion (ROM), visual analog scale (VAS) pain scores, Lysholm knee scores and complications were compared between the two groups. The curative effect of each group was calculated according to Judet’s criteria. Results The mean drainage volumes on postoperative day (POD) 1 and POD 2, and total drainage volume were significantly lower in the TXA group than in the control group (P < 0.001 for all). The TXA group had significantly lower postoperative CRP and IL-6 levels on POD 1 and POD 2, and at postoperative week (POW) 1 and POW 2 than the control group. The VAS pain scores in the TXA group were significantly lower on POD 1 and POD 2, and at POW 1 and POW 2 than those in the control group (P < 0.001 for all). Patients in the TXA group showed better postoperative ROM and Lysholm knee scores at POW 1 and POW 2. No patient had any complications such as deep venous thrombosis (DVT) or infection. The excellent and good rates of knee arthroscopic arthrolysis were comparable between the two groups at the sixth postoperative month (P = 0.536). Conclusions Topical administration of TXA in knee arthroscopic arthrolysis can reduce postoperative blood loss and inflammatory response, alleviate early postoperative pain, increase early postoperative knee ROM, and improve early postoperative knee function without increased risks.

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Section: Methodsmentioning

confidence: 99%

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

You

Yao

et al. 2023

BMC Musculoskelet Disord

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“…The authors recommend taking guidance based on the fat tissue surrounding the inner layer of the retinaculum, and the ligamentous layer immediately external to the fat tissue may be a useful anatomical mark of the limits of debridement. Also, special consideration should be given to adhesion formation due to intra-articular bleeding [ 37 ], which we have usually seen attached from the meniscus to the joint capsule, requiring identification and debridement.…”

Section: Discussionmentioning

confidence: 99%

A Balanced Arthroscopic Debridement of the Inner Layer of the Knee Retinaculum Increases the Tibiofemoral Joint Space Width

Yáñez-Diaz

Strömbäck

Vergara

et al. 2022

Advances in Orthopedics

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Introduction. Traditional techniques can enlarge the medial tibiofemoral joint space width (JSW) for meniscal repairs, but a remnant ligament laxity may be developed. Alternatively, the debridement of the inner retinaculum layer may result in a balanced JSW without causing extra-ligament damage (retinaculum layers II and collateral ligament). Purpose. The purpose of this study was to determine whether a concentric arthroscopic debridement of the inner retinaculum layer increases the tibiofemoral JSW in patients with meniscal injuries. Secondarily, we determine whether the increase in JSW is symmetrical between compartments and describe the rate of complications and patient satisfaction. Method. Twenty middle-aged (15 male and five female) patients diagnosed with acute meniscal injury aged 36 ± 12 years were enrolled. The patients were submitted to an arthroscopic debridement of the inner layer of the knee retinaculum for both the medial and lateral compartments. The tibiofemoral JSW was measured intra-articularly using a custom instrument. A two-way ANOVA for repeated measures was used to compare the JSW. A Bland–Altman analysis and test-retest analysis were performed. Results. The JSW increased following the debridement of the inner retinaculum layer, for both the medial and lateral compartments p < 0.001 . No complications were identified, and the patients were satisfied with the intervention. The minimal detectable change and bias of the custom instrument were 0.06 mm and 0.02 mm, respectively. Conclusion. The debridement allows a clinically important (>1 mm) symmetric tibiofemoral JSW enlargement. The technique suggests favoring the diagnosis of meniscus injuries and manipulating arthroscopic instruments without secondary complications after one year.

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“…Knee stiffness is the most frequent complication after patella fractures. It is highly associated with open fractures, infections, or inadequate rehabilitation protocols with prolonged immobilization [6] , [7] . The greater severity of the soft-tissue injury in open fractures facilitate arthrofibrosis and extra-articular adhesions (subcutaneous and quadriceps) [3] .…”

Section: Discussionmentioning

confidence: 99%

“…When conservative treatment fails, arthroscopic arthrolysis is the treatment of choice because of its minimally invasiveness. The outcomes are better if done during the first 6 months of follow-up [3] , [7] . Relative contraindications to this procedure are unresolved injuries to the extensor apparatus (such as an unconsolidated patella fracture), flexion contracture of the knee, and prior failure of arthroscopic treatment [3] , [6] , [7] .…”

Section: Discussionmentioning

confidence: 99%

“…The outcomes are better if done during the first 6 months of follow-up [3] , [7] . Relative contraindications to this procedure are unresolved injuries to the extensor apparatus (such as an unconsolidated patella fracture), flexion contracture of the knee, and prior failure of arthroscopic treatment [3] , [6] , [7] . Complications usually occur in relation to the forced movement done at the end of the procedure (fractures around the knee, cartilage injuries, and extensor apparatus disruption).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of a post-traumatic stiff knee after an open extensor apparatus injury by arthroscopic arthrolysis through a free flap

Lara

Aguilera-Sáez

Tomàs-Hernández

et al. 2021

Trauma Case Reports

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Comparison of minimally invasive arthrolysis vs. conventional arthrolysis for post-traumatic knee stiffness

Cited by 10 publications

References 22 publications

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

Topical administration of tranexamic acid reduces postoperative blood loss and inflammatory response in knee arthroscopic arthrolysis: a retrospective comparative study

A Balanced Arthroscopic Debridement of the Inner Layer of the Knee Retinaculum Increases the Tibiofemoral Joint Space Width

Treatment of a post-traumatic stiff knee after an open extensor apparatus injury by arthroscopic arthrolysis through a free flap

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