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ISSN 2007-8560 (Print)
Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2018, Number 3

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Ortho-tips 2018; 14 (3)

Arthrofibrosis in total knee arthroplasty

Cardona MJI, Cardona MJI, de la Rosa GA

Language: Spanish
References: 19
Page: 124-130
PDF size: 126.38 Kb.


ABSTRACT

Arthrofibrosis is a rare complication after total knee arthroplasty; when it occurs, it constitutes a severe complication. It has been defined as a loss in the range of movement (ROM) accompanied by pain; its clinical picture responds to an excessive synthesis of fibrous collagen tissue type I, III and IV. Although its pathophysiology remains uncertain, some risk factors have been identified; those associated with the patient are comorbidities such as diabetes mellitus, reflex sympathetic dystrophy and systemic inflammatory diseases, rheumatoid arthritis and ankylosing spondylitis. The limitation of the ROM prior to surgery is the most important factor and its association with previous surgery increases the risk of presentation. Postoperative factors include infection, heterotopic ossification, inadequate pain management, and an insufficient rehabilitation protocol. Finally, the factors associated with surgery represent the most common cause of postoperative stiffness and include errors in ligament balance, poor positioning of the implants and over dimensioning of the components. Treatment options, closed mobilizations under anesthesia (MUA), open or arthroscopic arthrolysis, offer uncertain and unfavorable results for restoring the range of motion. Revision surgery may be necessary in those cases where a technical error is well identified; considering the high risk of complications, an adequate preoperative planning is required.


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