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Open surgical release for arthrofibrosis best increases range of motion in TKA patients
Open surgical release provides the best increase in range of motion for patients treated for arthrofibrosis after total knee arthroplasty, according to results of this study.
U.K. researchers studied 798 patients who underwent treatment for arthrofibrosis following total knee arthroplasty from 1975 onward. Of the 25 studies in the computer database, they analyzed treatment by manipulation under anesthesia (MUA), open surgical release, arthroscopic debridement and revision TKA and compared the patients using the Knee Society Score and range of motion (ROM), according to the abstract.
“Our analysis suggests that open surgical release would be the most beneficial option for patients who are fit to undergo secondary surgery if their lifestyle requires a higher ROM for activities of daily living,” the researchers stated in the abstract, noting that most of the papers studied were retrospective. “However, there were methodological limitations as [the] majority of the papers were case series, which decreased the quality of the evidence available.”
While there was no significant difference in the Knee Society Score between the treatments, open surgical release increased ROM by 43.4°, according to the abstract. MUA and arthroscopic release increased ROM by a mean 38.4° 36.2°, respectively. Revision TKA provided the smallest increase in ROM, at 24.7°.