Authors
Bolotnikov M.A.1, Brizhan L.K.1, 2, Dzhodzhua A.V.1, Karpovich N.I.3
1 Pirogov National Medical and Surgical Center, Moscow
2 Main Military Clinical Hospital named after N.N.Burdenko, Moscow
3 RUDN University, Moscow
Abstract
Background: One of the most serious complications of total knee arthroplasty is contracture associated with the formation of coarse fibrous connective tissue in the joint cavity (arthrofibrosis). This complication occurs in
Aims: Improving the quality of care for patients with contractures after arthroplasty of the knee joint by improving the technique of arthroscopic arthrolysis.
Materials and methods: The work is a single-center, prospective, selective, non-controlled study. The object of the study was 57 patients with contractures of the knee joint after arthoplasty for idiopathic gonarthrosis of the III stage. There were 50 female (87,7%), 7 male (12,3%), and the average age of the patients was 63,8±12,2. For contracture after arthroplasty of the knee, arthroscopic arthrolysis was performed. The study was conducted from 2015 to 2019. The effectiveness of the treatment was evaluated by the change in the range of movements and functional indicators determined on the KSS scale before and after 2 weeks, 3, 6 and 12 months.
Results: The KSS scale on the indicator “total assessment of the knee joint” have significant differences at p<0,05 between periods: before surgery and after 0,5 months, 0,5 and 3 months, 3 and 6 months after surgery. Functional assessment of the knee joint has significant differences at p<0,05 between all periods presented, which indicates a slower recovery dynamics of this indicator. The range of movements has significant differences at p<0,5 between periods: before surgery and after 0,5 months, 0,5 and 3 months after surgery. This suggests that the range of movements achieved during the first 3 months after arthrolysis can be considered the final achievement. Complications of contracture developed in 5 (8,8%) patients. Four arthrolysis was performed in 4 (7,0%) patients. Revision arthroplasty with replacement of all components of the arthroplasty was performed in 3 cases (5,3%). Thus, within 12 months after the operation, there is a complete restoration of the functioning indicators of the knee joint, while the final restoration of the range of motion can be judged after 3 months. KSS scores recover more slowly — within
Conclusions: Thus, within 12 months after the operation, there is a complete restoration of the functioning indicators of the knee joint, while the final restoration of the range of motion can be judged after 3 months. KSS scores recover more slowly — within
Keywords: total knee arthroplasty, arthrofibrosis, knee joint contracture, arthroscopic arthrolysis.
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