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The Study of Arthroscopic Release in the Treatment of Knee Joint Stiffness

Author: SunChuan
Tutor: WangHong
School: Huazhong University of Science and Technology
Course: Surgery
Keywords: knee stiffness arthroscopy arthrolysis
CLC: R687.3
Type: Master's thesis
Year: 2011
Downloads: 11
Quote: 0
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Abstract


Objective: To investigate the feasibility and effect of the arthroscopictreatment for knee joint stiffness.Methods: From September 2008 to September 2010, 83 patients were treatedwith arthroscopic arthrolysis. The intra-articular adhesion bands andscarred tissues were removed, medial and lateral release of the patellarwas performed, the adhesion tissues between the shaft of femur and thevastus intermedius muscle were removed, and multipoint dissection ofcontracted quadriceps if necessary, arthrolysis combined withmanipulation, and then thorough hemostasis were carried out. Theconcurrent postoperative rehabilitation program was combined withpassive exercises, active exercises and drugs.Results: All patients were followed up, the follow-up period ranging from6 to 30 months, the average follow-up period was 14.5 months. The averagerange of motion improved from 37.9°(±26.2) pre- arthrolysis to 120.8°(±17.3)on table(P<0.01), but declined to 98.7°(±27.2) at thesix months follow, the improvement of the average range of motion at thesix months follow compared to pre-arthrolysis was statisticallysignificant(P<0.01), and the decrease of the average range of motionat the six months follow compared to on-table was statisticallysignificant(P<0.01). The average Lysholm knee score improved from 62.5(±14.5) pre- arthrolysis to 87.3(±9.6) at the six months follow(P<0.01). The average quadriceps femoris muscle strength improved from4.1(±0.5) grade pre- arthrolysis to 4.7(±0.4) grade at the threemonths follo(wP<0.01). There were 33 patients with a deficit of extension ≥10°, the average extension deficit declined from 22.8°(±15.0) pre-arthrolysis to 23°(±3) at the six months follow(P<0.01). There were5 patients with knee flexion<90°, the average flexion improved from 23°(±3) pre- arthrolysis to 4.3°(±6.3) at the six months follow(P<0.01 ) . The mean operating time was 117(±56.7) min. The meanpostoperative volume of draining was 150(±216) ml. The tear ofquadriceps tendon occurred in one patient, patellar fracture occurred inone patient, the tear of patellar ligament occurred in two patients, skindelayed union occurred in one patient,weakness of quadriceps femorismuscle occurred in one patient and poor effect with knee flexion<60°occurred in 10 patients post-arthrolysis. No infection, skin necrosiswas found.Conclusion: Arthroscopic arthrolysis is a good technique for thetreatment of knee joint stiffness. It has the advantages of minimallyinvasive, quickly recovery, early rehabilitation and less complications.It can thoroughly remove the adhesion tissue and deal with otherintra-articular problems coinstantaneously.

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CLC: > Medicine, health > Surgery > Orthopaedic Surgery ( movement system diseases,orthopedic surgery ) > Orthopedic surgery and surgery > Bone surgery
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