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Hydraulic distension of the knee: a novel treatment for arthrofibrosis after total knee replacement (case series)
Author(s) -
Formby Peter M.,
Donohue Michael A.,
Cannova Christopher J.,
Caulfield J. Patrick
Publication year - 2016
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13540
Subject(s) - medicine , arthrofibrosis , distension , surgery , total knee arthroplasty , anesthesia
Background Arthrofibrosis following total knee arthroplasty ( TKA ) is a common problem, which can be frustrating to both the patient and treating physician and can dramatically compromise post‐operative function. Current treatment options for TKA arthrofibrosis include watchful waiting, injections, physical therapy, manipulation under anaesthesia, arthroscopic/open lysis of adhesions and revision surgery. We present a novel technique to treat acute and chronic stiffness following TKA , which we call hydraulic distension. Methods A retrospective pre‐ and post‐operative inpatient and outpatient record review of three patients treated with hydraulic distension for arthrofibrosis following TKA at a single institution. Results Three patients with a mean age of 74 years (68–78) underwent hydraulic distension of the knee at a mean of 23.4 ± 18.4 months (9 weeks to 36 months) following primary TKA . The mean pre‐distension maximum flexion was 86.7 ± 10.4°, and the mean post‐distension flexion was 110 ± 13.2° (23.3° increase). The patients maintained a mean 110 ± 20° flexion (23.3° increase) at a mean follow‐up of 11.7 months (1 week to 29 months). There were no complications. Conclusion We present a novel technique for managing arthrofibrosis following TKA that has not been previously reported. This is an effective, safe procedure, with our patients experiencing a mean 23° increased knee flexion at the most recent follow‐up.