Sebastian Abin S, Sathikumar Aravind Sai, Thomas Appu Benny, Varghese Jacob
Division of Joint Replacement and Sports Medicine, VPS Lakeshore Hospital, Ernakulam, India.
Indian J Orthop. 2023 Dec 30;58(2):210-216. doi: 10.1007/s43465-023-01081-4. eCollection 2024 Feb.
To evaluate the functional outcomes of patients undergoing arthroscopic arthrolysis of the knee and find the ideal timing for arthrolysis to achieve maximum range of motion (ROM) of the knee.
All patients who underwent arthroscopic arthrolysis for post-operative joint stiffness following surgery for injuries around knee joint at a tertiary care centre from 2009 to 2023 were included in this study. The patients' details such as primary injury, time interval between the index surgery and arthrolysis, improvement in knee range of ROM and Lysholm score from prior to arthrolysis to last follow-up post arthrolysis were retrieved from hospital database and analysed.
Total of 42 patients who underwent arthroscopic arthrolysis of knee from 2009 to 2023 were included in this study. Follow-up range was 6 months to 6 years. ROM after arthrolysis significantly improved in the early and delayed arthrolysis groups as compared to late arthrolysis groups (mean 126.25 and 115.62 vs 106.3, < 0.05). Patients treated with early arthroscopic arthrolysis (within 3 months) showed significant increase in post operative Lysholm score compared to other groups ( < 0.05). ROM of 120° and beyond was achieved in 75% of cases in early arthrolysis group compared to 62.8% and 39% in delayed and late arthrolysis group ( < 0.05).
Arthroscopic arthrolysis done within 6 months (with maximum effect when done within 3 months) after the primary surgery leads to significant improvement in ROM and functional scores as compared to those with late arthrolysis group.
评估接受膝关节镜下粘连松解术患者的功能结局，并找出进行粘连松解术以实现膝关节最大活动范围（ROM）的理想时机。
本研究纳入了2009年至2023年在一家三级医疗中心因膝关节周围损伤手术后出现关节僵硬而接受膝关节镜下粘连松解术的所有患者。从医院数据库中检索患者的详细信息，如原发损伤、初次手术与粘连松解术之间的时间间隔、膝关节ROM的改善情况以及从粘连松解术前到粘连松解术后最后一次随访的Lysholm评分，并进行分析。
本研究纳入了2009年至2023年接受膝关节镜下粘连松解术的42例患者。随访时间为6个月至6年。与晚期粘连松解术组相比，早期和延迟粘连松解术组术后ROM有显著改善（平均126.25和115.62对106.3，P<0.05）。与其他组相比，早期（3个月内）接受膝关节镜下粘连松解术的患者术后Lysholm评分显著提高（P<0.05）。早期粘连松解术组75%的病例实现了120°及以上的ROM，而延迟和晚期粘连松解术组分别为62.8%和39%（P<0.05）。
与晚期粘连松解术组相比，初次手术后6个月内（3个月内效果最佳）进行的膝关节镜下粘连松解术可使ROM和功能评分显著改善。
