Kim Young-Mo, Joo Yong Bum
Department Orthopaedic Surgery, Chungnam National University Hospital, Daejeon, Korea.
Knee Surg Relat Res. 2013 Dec;25(4):202-6. doi: 10.5792/ksrr.2013.25.4.202. Epub 2013 Nov 29.
To assess the results of arthroscopic adhesiolysis for arthrofibrosis of the knee and to investigate possible prognostic factors.
Among the patients who developed arthrofibrosis after knee joint surgery, 68 patients who underwent arthroscopic adhesiolysis and were available for at least one-year follow-up were evaluated with regard to the Lysholm knee score, International Knee Documentation Committee (IKDC) subjective knee score, patient satisfaction, and range of motion (ROM) of the knee. The influence of possible prognostic factors including the cause of arthrofibrosis, duration of disease, and age of the patient on the postoperative ROM was analyzed.
Sixty-one patients (89.7%) obtained an average increase of 48.6° in ROM; however, the remaining seven patients (10.3%) did not show any increase at the final follow-up. The Lysholm knee score and IKDC subjective knee score increased significantly at the final follow-up. Patient satisfaction was high or very high in 89.7% of the patients at the final follow-up. There was no association between the cause of arthrofibrosis and the increase in postoperative ROM. The duration of disease was significantly related to the postoperative recovery of ROM. Age had no significant influence on the postoperative recovery of ROM.
We believe that arthroscopic adhesiolysis is effective for the treatment of intraarticular arthrofibrosis. In particular, the duration of the disease had significant influence on the postoperative outcome.
评估关节镜下粘连松解术治疗膝关节纤维性关节僵直的效果，并探讨可能的预后因素。
在膝关节手术后发生纤维性关节僵直的患者中，对68例行关节镜下粘连松解术且至少随访1年的患者进行了Lysholm膝关节评分、国际膝关节文献委员会（IKDC）主观膝关节评分、患者满意度及膝关节活动范围（ROM）评估。分析了包括纤维性关节僵直病因、病程及患者年龄等可能的预后因素对术后ROM的影响。
61例患者（89.7%）ROM平均增加48.6°；然而，其余7例患者（10.3%）在最终随访时未显示任何增加。最终随访时Lysholm膝关节评分和IKDC主观膝关节评分显著提高。最终随访时89.7%的患者对治疗的满意度为高或非常高。纤维性关节僵直的病因与术后ROM增加之间无相关性。病程与术后ROM恢复显著相关。年龄对术后ROM恢复无显著影响。
我们认为关节镜下粘连松解术治疗关节内纤维性关节僵直有效。特别是，病程对术后结果有显著影响。
