N°270 - January 2018
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Arthroscopic arthrolysis for stiffness after total knee arthroplasty
By Francois Kelberine, Jean-Philippe Vivona in category TECHNIQUE
Pôle Aixois de Chirurgie Articulaire et Sportive (PACAS) - Clinique Provençale Parc Rambot, Aix en Provence / e-mail : [email protected]
There has been a significant rise in the number of total knee arthroplasties (TKA) being performed. Knee arthroplasty is an effective treatment for advanced conditions and offers satisfactory long-term survival rates.
However, it is naturally associated with a risk of complications, one of which is stiffness, the incidence of which following TKA ranges from 1.3–7%[1,2,3], affecting activities of daily living.
Some believed that initially 70° of knee flexion was required for walking, 90° for stair ascent/descent and 105° for chair rising (4).
Stiffness can therefore be defined as having < 75° of flexion and/or a flexion contracture of 15°.[1,5]
However, this range of motion is clearly insufficient in younger and more active subjects who have greater functional and even sporting requirements, especially since a stiff knee is very often the cause of maltracking of the patella with pain and locking.
This is why we agree with Yercan2 that flexion of 95° and/or an extension deficit of -10° are an indication for arthrolysis, if the patient is experiencing functional impediment.
There are numerous causes, both intra- and extra-articular.
- Pre-operative (prior major surgery, previously stiff knee), intra-operative (technical error) and post-operative (insufficient...
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