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J Am Acad Orthop Surg, Vol 15, No 11, November 2007, 682-694.
© 2007 the American Academy of Orthopaedic Surgeons
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Arthrofibrosis of the Knee

David Magit, MD, Andy Wolff, MD, Karen Sutton, MD and Michael J. Medvecky, MD

Dr. Magit is Orthopaedic Surgeon, The Greenwich Sports and Shoulder Service, Orthopaedic and Neurosurgery Specialists PC, Greenwich, CT. Dr. Wolff is Fellow, Steadman Hawkins Clinic, Vail, CO. Dr. Sutton is Resident, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT. Dr. Medvecky is Assistant Professor, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Magit, Dr. Wolff, Dr. Sutton, and Dr. Medvecky.

Reprint requests: Dr. Magit, The Greenwich Sports and Shoulder Service, Orthopaedic and Neurosurgery Specialists PC, 6 Greenwich Office Park, 10 Valley Drive, Greenwich, CT 06831.

Better understanding of surgical timing, improved surgical technique, and advanced rehabilitation protocols has led to decreased incidence of motion loss after anterior cruciate ligament injury and reconstruction. However, motion loss from high-energy, multiligament injuries continues to compromise functional outcome. Prevention, consisting of control of inflammation and early motion, remains the key element in avoiding motion loss. However, certain techniques, such as manipulation under anesthesia in conjunction with arthroscopic lysis of adhesions, are reliable treatment options. Open surgical débridement is rarely necessary and should be considered only as a salvage procedure. A greater understanding of the pathogenesis of arthrofibrosis and related inflammatory mediators may result in novel therapies for treating the patient with motion loss.






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Copyright © 2007 by the American Academy of Orthopaedic Surgeons.