Klein W, Shah N, Gassen A
Sangini Bone and Joint Clinic, Ellisbridge, Ahamedabad, India.
Arthroscopy. 1994 Dec;10(6):591-7. doi: 10.1016/s0749-8063(05)80053-2.
From October 1987 through March 1991, 58 patients with postoperative joint stiffness underwent arthroscopic fibroarthrolysis. Forty-six knees in 46 patients were followed. The indication for arthroscopic management was decreased range of motion after surgery. Eighty-seven percent had been treated by arthrotomy. Thirteen percent had been managed by arthroscopic surgery. The indication for primary surgery was a torn anterior cruciate ligament in 74%. The mean interval between arthroscopic fibroarthrolysis and follow-up was 22.1 months. The average age was 32.7 years. A modified Blauth and Jäger score was used for classification of fibroarthrosis: grade I (mild 17.4%), grade II (moderate 63%), grade III (severe 15.2%), and grade IV (bad 4.3%). The gain in range of motion was evaluated by the Cauchoix index: the results were excellent in 54.5%, good in 21.7%, and fair and poor in 23.8%. Pain was evaluated according to a modification of the Lysholm score: 80.4% of the patients experienced a reduction in pain. The sports activity level in the Tegner activity scale increased from 2.3 to 4.8. Patient satisfaction was excellent or good in 56.5% (n = 26), fair in 39.1% (n = 18), and poor in 4.3% (n = 2). On the basis of our retrospective study, we feel that arthroscopic fibroarthrolysis is of benefit to the patients with postoperative joint stiffness even after a prolonged period.
1987年10月至1991年3月，58例术后关节僵硬患者接受了关节镜下纤维性关节松解术。对46例患者的46个膝关节进行了随访。关节镜治疗的指征是术后活动范围减小。87%的患者曾接受过切开手术，13%的患者接受过关节镜手术。初次手术的指征是74%的患者存在前交叉韧带撕裂。关节镜下纤维性关节松解术与随访之间的平均间隔为22.1个月。平均年龄为32.7岁。采用改良的布劳斯和耶格评分对纤维性关节病进行分类：I级（轻度，17.4%），II级（中度，63%），III级（重度，15.2%），IV级（差，4.3%）。采用考乔伊指数评估活动范围的增加情况：结果为优的占54.5%，良的占21.7%，中及差的占23.8%。根据改良的利绍姆评分评估疼痛情况：80.4%的患者疼痛减轻。特格纳活动量表中的体育活动水平从2.3提高到了4.8。56.5%（n = 26）的患者满意度为优或良，39.1%（n = 18）为中，4.3%（n = 2）为差。基于我们的回顾性研究，我们认为关节镜下纤维性关节松解术对术后关节僵硬患者有益，即使在较长时间后也是如此。
