Arthrofibrosis of the Knee
Arthrofibrosis of the Knee David Magit, MD Abstract Andy Wolff, MD Better understanding of surgical timing, improved surgical Karen Sutton, MD technique, and advanced rehabilitation protocols has led to Michael J. Medvecky, MD decreased incidence of motion loss after anterior cruciate ligament injury and reconstruction. However, motion loss from high-energy, multiligament injuries continues to compromise functional outcome. Prevention, consisting of control of inflammation and early motion, remains the key element in avoiding motion loss. However, certain techniques, such as manipulation under anesthesia in conjunction with arthroscopic lysis of adhesions, are reliable treatment options. Open surgical débridement is rarely necessary and should be considered only as a salvage procedure. A greater understanding of the pathogenesis of arthrofibrosis and related inflammatory mediators may result in novel therapies for treating the patient with motion loss. Dr. Magit is Orthopaedic Surgeon, The Greenwich Sports and Shoulder oss of knee motion is a devastat- tients with arthrofibrosis.1 Service, Orthopaedic and Neurosurgery Ling consequence of both single- Arthrofibrosis represents a wide Specialists PC, Greenwich, CT. Dr. and multiligamentous injury and spectrum of disease, ranging from lo- Wolff is Fellow, Steadman Hawkins their reconstruction. Increased recog- calized to diffuse involvement of all Clinic, Vail, CO. Dr. Sutton is Resident, nition of this problem in the past two compartments of the knee and of the Department of Orthopaedics and decades has led to better prevention extra-articular soft tissues. Preven- Rehabilitation, Yale University School of and improved management of these tion of motion loss remains essential Medicine, New Haven, CT. Dr. Medvecky injuries. Despite these advances, to successful outcome.
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