Arthrofibrosis After Total Knee Arthroplasty : Pathophysiology, Diagnosis, and Management - 11/05/19

Doi : 10.1016/j.ocl.2019.02.005

Ryan Thompson, BS ^a,^b, David Novikov, BS ^a, Zlatan Cizmic, MD ^a, James E. Feng, MD ^a, Kathryn Fideler, MD ^a,^c, Zain Sayeed, MD, MHA ^a,^b, Morteza Meftah, MD ^a, Afshin A. Anoushiravani, MD ^a,^d, Ran Schwarzkopf, MD, MSc ^e,^⁎
^a Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Langone Health, 301 East 17th Street, New York, NY 10003, USA
^b Department of Surgery, Chicago Medical School, North Chicago, IL, USA
^c Department of Orthopaedic Surgery, Wexner Medical Center, Ohio State University, Columbus, OH, USA
^d Department of Orthopaedic Surgery, Albany Medical Center, Albany, NY, USA
^e Division of Adult Reconstructive Surgery, Department of Orthopaedic Surgery, NYU Langone Orthopedics, NYU Langone Health, 301 East 17th Street, New York, NY 10003, USA

^∗Corresponding author.

Résumé

Arthrofibrosis is the pathologic stiffening of a joint caused by an exaggerated inflammatory response. As a common complication following total knee arthroplasty (TKA), this benign-appearing connective tissue hyperplasia can cause significant disability among patients because the concomitant knee pain and restricted range of motion severely hinder postoperative rehabilitation, clinical outcomes, and basic activities of daily living. The most effective management for arthrofibrosis in the setting of TKA is prevention, including preoperative patient education programs, aggressive postoperative physical therapy regimens, and anti-inflammatory medications. Operative treatments include manipulation under anesthesia, arthroscopic debridement, and quadricepsplasty.

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Keywords : Total knee arthroplasty, Arthrofibrosis, Manipulation under anesthesia, Arthroscopic debridement, Quadricepsplasty