According to recently published results, manipulation under anesthesia with lysis of adhesions is an effective procedure for patients with arthrofibrosis after sulcus-deepening trochleoplasty.
Researchers identified 62 knees with severe trochlear dysplasia that underwent sulcus-deepening trochleoplasty. The mean follow-up was 32.5 months. Medial patellofemoral ligament reconstruction, lateral retinacular release and tibial tubercle osteotomy were among the concomitant procedures. During the physical examination, investigators collected range of motion outcomes and recurrent patellar instability findings. The primary outcome of the study was range of motion (ROM) after the initial procedure and after manipulation under anesthesia or manipulation under anesthesia with lysis of adhesions.
“Arthrofibrosis was defined as active and passive flexion less than 90° within 3 months of surgery combined with a plateau in progress with physical therapy,” the researchers wrote.
Results showed arthrofibrosis as a complication in 11 patients. These patients underwent manipulation under anesthesia within 3 months of their initial surgery.
Of the 11 patients, nine patients subsequently underwent arthroscopic lysis of adhesions after manipulation under anesthesia. Manipulation alone was not enough for these patients to achieve acceptable ROM. Compared with those without arthrofibrosis, patients with arthrofibrosis had a mean pre-manipulation ROM that was significantly different (133.3° vs. 77.3°, respectively ). Postoperative ROM significantly increased after manipulation under anesthesia and/or lysis of adhesions in patients with arthrofibrosis compared with preoperative ROM (127.3° vs. 77.3°).
The ROM was not significantly different between patients with arthrofibrosis compared to those without it after manipulation under anesthesia with lysis of adhesions (127.3° vs. 133.3°). At the subsequent follow-ups, there were no complications seen after manipulation under anesthesia or lysis of adhesions. – by Monica Jaramillo
Disclosures: Carstensen reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.