Arthrofibrosis after total knee arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Persistent limited motion (stiffness) is a complication following total knee arthroplasty (TKA).
• Arthrofibrosis, characterized by extensive scar tissue formation, can significantly impair joint function after TKA.

Purpose of the Study:

• To evaluate the effectiveness of revision surgery for TKA in patients with arthrofibrosis and limited range of motion.
• To identify potential causes and outcomes associated with stiffness after primary TKA.

Main Methods:

• Retrospective review of six TKAs in five patients undergoing revision surgery for limited motion.
• Assessment of implant positioning, component type (posterior cruciate retaining or substituting), and range of motion before and after revision.
• Evaluation of heterotopic bone formation and soft tissue contracture as causes of stiffness.

Main Results:

• Revision surgery significantly increased the arc of motion from an average of 36 degrees to 86 degrees.
• No implant malposition or incorrect sizing was identified as the cause of stiffness.
• Soft tissue contracture was the primary identified cause of limited motion; heterotopic bone formation was observed in some cases.

Conclusions:

• Revision surgery can effectively restore range of motion in TKA patients suffering from arthrofibrosis and soft tissue contracture.
• The exact triggers for scar tissue proliferation in arthrofibrosis remain unclear, potentially involving patient predisposition or response to surgical trauma.
• While challenging, revision surgery offers a viable option for improving function and pain in cases of post-TKA arthrofibrosis.