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The Surgical Treatment of Arthrofibrosis of the Knee

Sixty-one lysis of adhesion procedures were performed for arthrofibrosis of the knee between 1981 and 1990. In 43 cases (37 patients) the etiology was prior knee ligament surgery. Ten cases had sustained fractures about the knee and eight had miscellaneous etiologies. Six patients required a second lysis of adhesion pro cedure. A retrospective analysis of the 43 ligament pa tients was undertaken to evaluate the results of surgical treatment. All 43 cases were available for followup at an average of 3.6 years. Surgical indications included flex ion or extension deficits of ≥10° or when motion failed to improve despite 2 months of intense therapy. Follow-up assessment included clinical and radio graphic evaluation. Flexion improved from 83% to 97% of the contralateral side. Extension deficits improved from 14° to 3°. Only 23 of 37 patients (62%) achieved satisfactory functional results. Radiographic evidence of degenerative changes, soft tissue calcification, and patella infera was found in 89%, 51 %, and 9% of the patients, respectively. Patients requiring surgical treat ment for arthrofibrosis after knee ligament surgery achieved excellent motion gains, but functional out come scores were compromised and radiographic find ings were concerning. Patients with the localized an terior intraarticular variant or those undergoing lysis of adhesion surgery sooner than 6 months had outcomes comparable with controls.