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Arthroscopic lysis of adhesions, manipulation yielded greater improvements for arthrofibrosis following TKA vs manipulation alone
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According to a recently published study, greater increases were seen in final knee flexion and mean knee range of motion among patients who underwent arthroscopic lysis of adhesions and manipulation under anesthesia for treatment of arthrofibrosis after total knee arthroplasty compared with patients who only underwent manipulation under anesthesia.
“In our patient population, we observed benefit to concurrently performing manipulation under anesthesia with arthroscopic lysis of adhesions to combat stiffness and flexion contracture post TKA; we believe this should be considered as a treatment option, especially in patients with a severe stiffness," Elan M. Volchenko, MD, told Healio.com/Orthopedics. "A related area of interest for us is the comparison of [manipulation under anesthesia] MUA plus [arthroscopic lysis of adhesions] ALOA concurrently, with the use of ALOA in a stepwise manner after failed manipulation.”
Researchers identified 70 patients with arthrofibrosis after total knee arthroplasty. Thirty-five patients were treated with only manipulation under anesthesia (MUA) and 35 patients were treated with arthroscopic lysis of adhesions and MUA. Information was collected with electronic records. Investigators matched cohorts based on age, sex, BMI, diabetes mellitus, perioperative range of motion (ROM) and timing of the procedure for arthrofibrosis.
Among patients who received both MUA and arthroscopic lysis, results showed a 72.7% increase in ROM at 4 to 12 weeks after TKA and a 50% increase at more than 12 weeks. Patients with a pre-manipulation ROM of 0° to 60° had a 99.8% increase. There was a 49.2% increase in ROM 4 to 12 weeks after TKA in patients who underwent MUA alone and a 27% increase at more than 12 weeks. For patients with pre-manipulation ROM of 0° to 60°, there was a 68.6% increase.
According to researchers, patients treated with arthroscopic lysis of adhesions and MUA saw greater increases in ROM and final knee flexion compared to patients treated with MUA alone. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.
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