Arthroscopic Lysis of Adhesions for Treatment of Post-Traumatic Knee Arthrofibrosis: A Prospective Study

Karim M Abdelghafour; Ahmed S Elkalyoby; Mohammad H Amer; M K Abdelaziz

doi:10.7759/cureus.33275

Arthroscopic Lysis of Adhesions for Treatment of Post-Traumatic Knee Arthrofibrosis: A Prospective Study

Cureus. 2023 Jan 2;15(1):e33275. doi: 10.7759/cureus.33275. eCollection 2023 Jan.

Authors

Karim M Abdelghafour^{1

2}, Ahmed S Elkalyoby¹, Mohammad H Amer^{1

3}, M K Abdelaziz¹

Affiliations

¹ Trauma and Orthopaedics, Cairo University, Cairo, EGY.
² Trauma and Orthopaedics, East and North Hertfordshire NHS (National Health Service) Trust Lister Hospital, Stevenage, GBR.
³ Trauma and Orthopaedics, Royal Sussex County Hospital, University Hospitals of Sussex, Brighton, GBR.

Abstract

Background: Post-traumatic knee arthrofibrosis can have a significant effect on patients' function and the management can be challenging with a variety of options ranging from manipulation under anaesthesia (MUA) to more invasive procedures such as quadricepsplasty. The aim of the study is to evaluate the improvement of both knee range of motion (ROM) and functional outcomes after arthroscopic lysis of adhesions (ALA) for post-traumatic knee arthrofibrosis.

Materials and methods: A prospective study of 30 patients with post-traumatic knee arthrofibrosis was managed by arthroscopic arthrolysis. Aggressive rehabilitation protocol was initiated on the first day postoperatively. Comprehensive clinical follow-up evaluations including the ROM assessment and the Lysholm score were done for all patients.

Results: The mean age was 36.17 years (±9.51). The mean follow-up time was 6.7 months (six to nine months). The ROM improved from 75° (±10.91°) preoperatively to 119.83° (± 10.38°) at the final follow-up (P < 0.001). Additionally, the Lysholm score increased from 56.90(±2.64) preoperatively to 85.27(±3.46) (P < 0.001). The ultimate final ROM and functional outcomes for all patients were satisfactory.

Conclusion: ALA for knee arthrofibrosis significantly improves the knee ROM and functional outcomes and can be a successful alternative to open quadricepsplasty.

Keywords: adhesions; arthroscopic lysis; knee arthrofibrosis; lysholm score; range of motion; stiffness.