Revision Total Knee Arthroplasty for Arthrofibrosis

Area of Science:

• Orthopedics
• Biomedical Engineering
• Rehabilitation Medicine

Background:

• Arthrofibrosis is a frequent complication following primary total knee arthroplasty (TKA), leading to significant patient dissatisfaction.
• The rising incidence of TKA in the U.S. is projected to increase the prevalence of arthrofibrosis, estimated between 1.3% and 5.3%.
• This condition imposes a substantial burden on the healthcare system, accounting for 27.5% of 90-day readmissions after TKA.

Purpose of the Study:

• To summarize the current understanding of arthrofibrosis after TKA.
• To highlight the challenges in defining and diagnosing arthrofibrosis.
• To outline the management strategies for TKA arthrofibrosis.

Main Methods:

• Literature review of arthrofibrosis prevalence, definition, and management.
• Analysis of healthcare system burden related to TKA arthrofibrosis.
• Discussion of nonoperative and operative treatment modalities.

Main Results:

• Prevalence estimates for arthrofibrosis vary due to differing diagnostic criteria.
• Arthrofibrosis leads to pain, abnormal gait, fatigue, and functional limitations.
• Physical therapy and manipulation under anesthesia (MUA) are primary nonoperative treatments.

Conclusions:

• Arthrofibrosis management requires a clear definition and consistent diagnostic thresholds.
• Nonoperative treatments, particularly physical therapy, are the mainstay of management.
• Revision arthroplasty is reserved for refractory cases, emphasizing the importance of timely and appropriate nonoperative care.