Arthrofibrosis of the knee: clinical result after early vs. late arthroscopic arthrolysis of 100 patients

Abstract

Aims and Objectives:Distal femoral or tibial fractures as well as anterior cruciate ligament (ACL) tears can be associated with postoperative arthrofibrosis of the knee. So far, there are only a few studies that analyse this entity. The aim of the study is to evaluate potential risk factors that influence the outcome of patients with arthrofibrosis. We hypothesize that early arthroscopic arthrolysis is associated with a better postoperative outcome.Materials and Methods:100 patients (at the time of the abstract submission n=59) with arthroscopic arthrolysis of postoperative arthrofibrosis of the knee were included in the retrospective study. They were clinically examined with a minimum follow-up of 2 years (mean 25±6 months). Arthrofibrosis was shown in 51% of the cases after ACL lesions, in 14% after femoral and tibial fractures, in 12% after infection and in 10% after patella fractures.The study population was divided into early (less than 3 months; n=19, mean 1.5 months) and late (more than 3 months; n=40, mean 8.7 months) arthroscopic arthrolysis after primary surgery.Results:In 51% of the cases (n=30) a normal range of motion could be postoperatively achieved (extension/flexion 0/140°). Patients with early arthroscopic arthrolysis showed significant more often a normal postoperative range of motion in comparison to patients with late revision (84% vs. 35%; p<0.001). Furthermore, patients with early arthrolysis had a significant lower postoperative flexion deficit than the late arthrolysis group (4° vs. 27°, p<0.001). The postoperative extension deficit was also significantly lower in the early arthrolysis group (0.4° vs. 3°; p=0,021).Postoperative functional scores were significantly higher after arthroscopic arthrolysis in comparison to before arthrolysis (Lysholm 85,1±11 vs. 41,3±9, p=0,049; Tegner 6,1±1 vs. 3,2±2, p=0,035; Cincinnati Rating Scale 83,1±13 vs. 52,1±16, p=0,046).Conclusion:Arthrofibrosis of the knee can be successfully treated with arthroscopic arthrolysis. Good postoperative results can be gained in treating flexion and extension deficits. Early arthroscopic arthrolysis shows significant better results in postoperative range of motion in comparison to late arthroscopic arthrolysis.