Author(s): Dr. Hiren Bhalala, Dr. Abhishek Jaroli, Dr. Gajanan Dhaked and Dr. Harish Rajpurohit

Abstract: Treatment of stiff, arthrofibrotic knee is challenging for the orthopedic surgeon, physiotherapist and for the patient. Various treatment modalities exist from conservative physical therapy, manipulation under anesthesia to surgical management with variable outcome. Our study aims to analyze the outcome of such knees with arthroscopic arthrofibrolysis and also its co relation to etiology and interval between treatments. Our study is analysis of 22 case of stiff knee which were treated with arthroscopic arthrofibrolysis. Analysis was done by using modified Blauth and Jager scoring system. As per Modified Blauth and Jager Scoring, 14 cases (63.6%) had grade IV decrease in range of motion preoperatively, 8 cases (36.4%) had grade III (severe) and none were in grade II (moderate) or grade I (mild). Out of 14 patients who had preoperative Score of IV, 10 improved to Score III and 4 had score II postoperatively at 6 months, which was significant (P<0.001). Similarly, all 8 patients who had preoperative score of III has significant improvement to score II postoperatively at 6 months (P<0.001). All patients had a range of flexion limited to less than 70⁰ preoperatively. The mean flexion was 34.77⁰ ± 21.70⁰ preoperatively, improved to 86.36⁰ ± 19.47⁰ post-operatively at 6 month. 15 out of 22 patients (68.18%) had a range of flexion 90⁰ and above postoperatively at 6 months, with mean gain in flexion 51.591⁰ (P<0.001). In our experience arthroscopic treatment of fibroarthrosis in the knee joint is a successful procedure. The goal of arthroscopic fibroarthrolysis is primarily to provide functional range of motion. However, our experience showed that the function of the joint can be improved even in cases with complex pathologies and after a prolonged interval between treatments.

DOI: https://doi.org/10.33545/orthor.2020.v4.i4a.268