The Benefit of Arthroscopy for Symptomatic Total Knee Arthroplasty

Teng, Hsiu-Peng; Chou, Yi-Jiun; Lin, Li-Chun; Wong, Chi-Yin

doi:10.1016/s1607-551x(09)70245-1

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…Another study concluded that arthroscopy is helpful for intra-articular diagnosis, and for better range of motion, and proved to be a safe, reliable and effective method of treatment [42]. The rehabilitation was also found to be easier and much quicker [22].…”

Section: Discussionmentioning

confidence: 98%

“…Klinger et al [27] performed a study on a series of 27 patients, and his results showed that arthroscopy after total knee replacement gives reliable expectation for improvement in function, decrease in pain and improvement for knee scores for most patients. Another study concluded that arthroscopy is helpful for intra‐articular diagnosis, and for better range of motion, and proved to be a safe, reliable and effective method of treatment [42]. The rehabilitation was also found to be easier and much quicker [22].…”

Section: Discussionmentioning

confidence: 99%

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Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement

Jerosch

Aldawoudy

2006

Knee Surg Sports Traumatol Arthr

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The purpose of this study was to document the effect of arthroscopic management in patients with knee stiffness after total knee replacement. We present a case series study, in which 32 patients have been treated for moderate arthrofibrosis of the knee after total knee replacement, with the same regimen. We have excluded all cases of stiffness, because of infection, mechanical mal-alignment, loosening of the implants and other obvious reasons of stiffness of the knee, rather than pure arthrofibrosis. All patients first underwent a trial of conservative treatment before going for arthroscopic management. A pain catheter for femoral nerve block was inserted just before anesthesia for post-operative pain management. Arthroscopic arthrolysis of the intra-articular pathology was performed in a standardized technique with release of all fibrous bands in the suprapatellar pouch, reestablishing the medial and lateral gutter, release of the patella, resection of the remaining meniscal tissue or an anterior cyclops, if needed. Intensive physiotherapy and continuous passive motion were to start immediately post-operatively. All the patients were available for the follow up and they were evaluated using the knee society rating system. A total of 25 of the 32 procedures resulted in an improvement of the patients knee score. All the knees operated upon had intra-articular fibrous bands, hypertrophic synovitis and peri-patellar adhesions. A total of eight patients suffered from an anterior cyclops lesion and six patients showed pseudomenicus. In 19 cases a medial and lateral relapse of the patella was performed; only 5 patients got an isolated lateral release. The mean knee flexion was 119 degrees (100-130) at the end of arthroscopy and was 97 degrees (75-115) at the last follow up. The eight patients with extension lags decreased from 27 degrees (10 degrees-35 degrees) pre-operatively to 4 degrees (0-10) at time of follow up. The average knee society ratings increased from 70 points prior to the arthroscopy to 86 at time of follow up, which was found to be statistically significant (P < 0.01, student's t test). The average function score also showed improvement from 68 points pre-operatively to 85 at the time of final follow up. The average pain scores improved from 30 points pre-operatively to 41 at the time of final follow up. Our results showed that arthroscopic management of knee stiffness following total knee replacement is a safe and efficient method of treatment. Pain and functional knee scores can improve markedly.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement

Jerosch

Aldawoudy

2006

Knee Surg Sports Traumatol Arthr

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“…Soft tissue impingements of several pathological entities have been reported. Patellar clunk syndrome (PCS) [ 10 - 13 ] and patellar synovial hyperplasia (PSH) [ 10 , 14 , 15 ] are the two main entities of impingement; however, other types of impingement including soft tissue impingement at the intercondylar notch [ 16 ], impingement of the posterior cruciate ligament stump [ 14 , 17 , 18 ], and arthrofibrosis [ 17 - 20 ] have also been reported. In these diseases, if the patients are resistant to conservative treatment, arthroscopic surgery is indicated instead of revision surgery in many cases [ 10 , 12 , 18 ].…”

Section: Introductonmentioning

confidence: 99%

Painful Knee is not Uncommon after total Knee Arthroplasty and can be Treated by Arthroscopic Debridement

Sekiya¹

2017

TOORTHJ

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Background:After total knee arthroplasty (TKA), most patients have an improvement; however, a few continue to have residual pain. We reported a case series of painful knee after TKA with unreported reason.Material and Methods:Forty-six arthroscopic surgeries were performed for painful knee after TKA. Of these, 16 were excluded due to infection, patellar clunk syndrome, patellofemoral synovial hyperplasia, aseptic loosening, or short follow up less than 6 months. Remaining 30 cases had marked tenderness at the medial and/or lateral tibiofemoral joint space, and they had pain during walking with pain or without pain at rest. The mean period from initial TKA to arthroscopy was 29 months, and the mean follow-up after arthroscopy was 36 months. All arthroscopic debridement was performed through 3 portals. Scar tissue impingements graded moderate or severe were found only in 30% of the cases in both the medial and lateral tibiofemoral joint spaces. The infrapatellar fat pad was covered with whitish scar tissue in all cases, and the tissue was connected with the scar tissue at the medial or lateral tibiofemoral joint spaces. All scar tissue was removed with a motorized shaver or punches.Results:At the final follow-up, 63% were pain free, 3% had marked improvement, 20% had half improvement, 3% had slight improvement, and 11% had no change. We hypothesized that the lesser mobility of the scar tissue due to the continuity of the tissue between the infrapatellar fat pad and the tibiofemoral joint space could cause easy impingement at the tibiofemoral joint, even with the small volume of scar tissue.Conclusion:If infection and aseptic loosening could be ruled out in a painful knee after TKA, arthroscopic debridement appeared to be a good option to resolve the pain.

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Arthroskopie an Kunstgelenken

Möckel

Labs

2008

Arthroskopie

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The Benefit of Arthroscopy for Symptomatic Total Knee Arthroplasty

Cited by 6 publications

References 7 publications

Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement

Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement

Painful Knee is not Uncommon after total Knee Arthroplasty and can be Treated by Arthroscopic Debridement

Arthroskopie an Kunstgelenken

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