Riel K A, Dörr A, Bernett P
Klinik und Poliklinik für Sportverletzungen, Technischen Universität München.
Unfallchirurg. 1990 Feb;93(2):73-6.
Knee joint stiffness first of all calls for physiotherapy, ranging from exercise therapy to a passive-immobilization splint. If no progress can be achieved, narcosis mobilization and brisement modéré should be done. If narcosis mobilization does not yield acceptable results, then surgical dissolution and arthrolysis should be performed. Thirty-seven patients with painless fibrous knee-joint stiffness following ligament reconstructions showed a reduction in mobility of 0 degree-20 degrees-80 degrees on average. After narcosis mobilization, full extension and bending could be achieved in 28 patients. In 9 patients, arthrolysis had to be carried out. At follow-up examination 1/2 to 3 1/2 years later, all 37 patients showed an increase in movement of 0 degree-0 degree-125 degrees on average. The "relative gain," the quotient of achieved and possible gain of movement in percentage, ranged from 88% to 96% on average. Other kind of loss of movement, patient age, or sex had no influence on the results. Twenty-six patients were able to participate in sports again due to the increase in movement potential. In the last few years, we have come to prefer arthroscopical arthrolysis instead of surgical arthrolysis when narcosis mobilization fails.
膝关节僵硬首先需要进行物理治疗，从运动疗法到被动固定夹板。如果没有进展，则应进行麻醉下活动和轻柔手法松解。如果麻醉下活动不能取得可接受的效果，那么就应进行手术松解和关节松动术。37例韧带重建后无痛性纤维性膝关节僵硬患者平均活动度从0度-20度-80度下降。麻醉下活动后，28例患者可实现完全伸直和弯曲。9例患者必须进行关节松动术。在1/2至3 1/2年后的随访检查中，所有37例患者平均活动度增加了0度-0度-125度。“相对增益”，即实际获得的运动增益与可能获得的运动增益的百分比商，平均范围为88%至96%。其他类型的运动丧失、患者年龄或性别对结果没有影响。由于运动潜能增加，26例患者能够再次参加体育运动。在过去几年中，当麻醉下活动失败时，我们更倾向于采用关节镜下关节松动术而非手术关节松动术。
