Long-term Results of Arthroscopic Arthrolysis for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction

Mayr, Hermann O.; Brandt, Christian M.; Weig, Thomas; Köhne, Manuel; Bernstein, Anke; Südkamp, Norbert P.; Hube, Robert und Stöhr, Amelie (2017): Long-term Results of Arthroscopic Arthrolysis for Arthrofibrosis After Anterior Cruciate Ligament Reconstruction. In: Arthroscopy-the Journal of Arthroscopic and Related Surgery, Bd. 33, Nr. 2: S. 408-414

Abstract

Purpose: The current study was conducted to evaluate the long-term clinical and radiological outcomes after arthroscopic arthrolysis for arthrofibrosis after anterior cruciate ligament reconstruction (ACLR). Methods: All patients treated with arthrolysis between 1990 and 1998 were included. Indication was arthrofibrosis in at least one knee compartment or a cyclops syndrome limiting range of motion (ROM) by > 5 degrees of extension deficit and 15 degrees of flexion deficit. International Knee Documentation Committee (IKDC) 2000 subjective and objective, Lysholm score, and x-ray evaluation were documented. Statistical analysis and power calculation were performed (P<.05). Results: One hundred forty-one patients (follow-up, 71%) were examined at a mean of 18.7 +/- 2.6 years after arthroscopic arthrolysis. Mean IKDC 2000 score was 79.49 +/- 14.32. IKDC objective was normal in 0%, nearly normal in 6%, abnormal in 56%, and severely abnormal in 38%. One hundred percent of patients showed more than grade II osteoarthritis. ROM improvement after arthrolysis did not change significantly compared with midterm results (t= 4.5 years). Patients with persisting motion deficits (P=.02) and after medial meniscus resection (P<.001) at time of ACLR showed significantly greater progression of osteoarthritis in comparison with patients without these additional disorders. In case of arthrolysis later than 1 year after ACLR, a more severe osteoarthritis grade (4% vs 20% grade III;P=.038) and a lower jump distance (IKDC: 61% A, 25% B vs 39% A, 41% B;P=.028) were obvious compared with patients who underwent arthrolysis within the first year after ACLR. Conclusions: Long-term motion improvement can be achieved by arthrolysis. Persistent loss of motion resulted in a higher degree of osteoarthritis in the study population. Early intervention seems advisable as patients with arthrolysis later than 1 year after index surgery reached worse IKDC objective grading. Level of Evidence: Level IV, therapeutic case series.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0749-8063
• Sprache: Englisch