Arthroscopic fibroarthrolysis and mobilization under anesthesia is a simple, reproducible, and satisfactory method for the treatment of patients with severe post-traumatic arthrofibrosis of the knee

• Published in: Revista española de cirugía ortopédica y traumatología 2024-07
• Main Authors: Franulic, N., Laso, J., Del Pino, C., Brito, C., Olivieri, R., Gaggero, N.
• Format: Article
• Language: English
• Subjects: Arthroscopic fibroarthrolysis; Artrofibrosis de rodilla; Fibroartrolísis artroscópica; Knee arthrofibrosis; Manipulation under anesthesia; Movilización bajo anestesia; Post-traumatic; Postraumática
• ISSN: 1888-4415; 1988-8856; 1988-8856
• DOI: 10.1016/j.recot.2024.07.008

To evaluate the range of motion (ROM) of the knee in patients with severe post-traumatic knee arthrofibrosis after being treated with arthroscopic fibroarthrolysis (AFA) and manipulation under anesthesia (MUA). Case series of patients with severe post-traumatic knee arthrofibrosis who underwent AFL+MUA in a national referral center. The primary outcome to be assessed was ROM before and after surgery and then at 3-month intervals until a minimum follow-up of one year was completed. 51 patients were included. The main injuries preceding the stiffness were tibial plateau fracture (37.3%), distal femur fracture (27.5%), and femoral shaft fracture (15.7%). Forty-five patients had severe flexion deficits with a median preoperative flexion of 70°. Intraoperative flexion significantly improved to 110°. Significant loss of flexion was observed at 3 and 6 months, however, patients regained ROM in the 9 and 12-month follow-ups. At discharge, 80% of the patients achieved flexion of 90° or more. There were 4 intraoperative complications and 3 reinterventions were performed. AFA+MUA can help patients with severe post-traumatic knee arthrofibrosis to recover ROM in most cases. However, this procedure is not without risks and complications, therefore, careful consideration should be given to its indication and execution. Evaluar el rango de movimiento (ROM) de la rodilla en los pacientes con artrofibrosis postraumática severa de la rodilla después de ser tratados con fibroartrolísis artroscópica (FAA) y movilización bajo anestesia (MBA). Serie de casos de pacientes con artrofibrosis postraumática severa de la rodilla sometidos a una FAA+MBA en un centro nacional de referencia. El resultado primario a evaluar fue el ROM antes y después de la cirugía y luego a intervalos de 3 meses hasta completar un seguimiento mínimo de un año. Se incluyeron 51 pacientes. Las principales lesiones precedentes a la rigidez fueron fractura de platillo tibial (37,3%), de fémur distal (27,5%) y de diáfisis femoral (15,7%). Cuarenta y cinco pacientes tenían un déficit de flexión severo con una flexión preoperatoria mediana de 70°. La flexión intraoperatoria mejoró significativamente a 110°. Se observó una pérdida significativa de flexión a los 3 y 6 meses, sin embargo, los pacientes recuperaron ROM en los seguimientos de 9 y 12 meses. Al momento del alta, el 80% de los pacientes alcanzó una flexión de 90° o más. Hubo 4 complicaciones intraoperatorias y se realizaron 3 reintervenciones. La FAA+M