Dataset Information

Arthroscopic Lysis of Adhesions and Anterior Interval Release With Manipulation Under Anesthesia for Severe Post-traumatic Knee Stiffness: A Simple and Reproducible Step-by-Step Guide.

ABSTRACT: Post-traumatic knee stiffness can present after injuries around the knee and surgery. Management is guided by the type of initial injury, amount of range-of-motion loss, time since injury, and cartilage status. Cases refractory to conservative management may conventionally be treated with manipulation under anesthesia (MUA), arthroscopic lysis of adhesions, or open quadricepsplasty. We describe our arthroscopic technique of lysis of adhesions with anterior interval release and intraoperative MUA, which has been shown to provide sustainable range-of-motion improvement in a subset of patients with severe knee arthrofibrosis. Although technically demanding, this technique benefits from being minimally invasive, allows for direct visualization of intra-articular structures, and allows all-round arthroscopic release of adhesions to improve patellar mobility and decrease the risk of fracture prior to MUA. A rigorous postoperative formal physical therapy protocol and patient compliance are imperative to achieve good outcomes.

SUBMITTER: Kukreja M

PROVIDER: S-EPMC6554358 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Arthroscopic Lysis of Adhesions and Anterior Interval Release With Manipulation Under Anesthesia for Severe Post-traumatic Knee Stiffness: A Simple and Reproducible Step-by-Step Guide.

Kukreja Mohit M Kang Jeansol J Curry Emily J EJ Li Xinning X

Arthroscopy techniques 20190411 5

Post-traumatic knee stiffness can present after injuries around the knee and surgery. Management is guided by the type of initial injury, amount of range-of-motion loss, time since injury, and cartilage status. Cases refractory to conservative management may conventionally be treated with manipulation under anesthesia (MUA), arthroscopic lysis of adhesions, or open quadricepsplasty. We describe our arthroscopic technique of lysis of adhesions with anterior interval release and intraoperative MUA ...[more]

PMID: 31194118

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Project description:PurposeTo compare 90-day postoperative complications, health care use, 2-year and 5-year rates of reoperation and manipulation under anesthesia, and costs at the 30-day, 90-day, and 1-year postoperative intervals following open and arthroscopic rotator cuff repair (RCR).MethodsPatients who underwent an open or arthroscopic RCR with minimum 5-year follow-up were identified in a national database (PearlDiver Technologies) using Common Procedural Terminology and International Classification of Diseases codes. These patients were then stratified into 2 cohorts: open RCRs and arthroscopic RCRs. These cohorts were propensity-matched based on age, sex, Charlson Comorbidity Index, smoking status, and obesity (body mass index>30). 90-day medical complications, 2-year and 5-year surgical complications, and reimbursements at the 30-day, 90-day and 1-year postoperative intervals were assessed. Bivariate statistics were performed using χ2 tests, Fisher exact tests, and Student t tests where appropriate. Reimbursements included the reimbursement for the index surgery as well as any reimbursements during the specified postoperative interval related to the index surgery.ResultsIn total, 3,266 patients who underwent open RCR were matched with 3,266 patients who underwent arthroscopic RCR. Compared with patients who underwent arthroscopic RCR, patients who underwent open RCR were at significantly increased risk of 90-day surgical-site infection (0.89% vs 0.34%, P = .004), undergoing manipulation under anesthesia (MUA) within 2 years of surgery (1.65% vs 0.95%, P = .012), and undergoing MUA within 5 years of surgery (1.75% vs 1.10%, P = .028). There were no significant differences in any other postoperative complications, reoperation rates, or reimbursements between open RCR and arthroscopic RCR (all, P > .05).ConclusionsPatients undergoing open RCR were at increased risk of 90-day surgical-site infection and MUA both within 2 years and within 5 years of surgery in this study cohort.Level of evidenceLevel III, retrospective cohort study.

Dataset Information

Arthroscopic Lysis of Adhesions and Anterior Interval Release With Manipulation Under Anesthesia for Severe Post-traumatic Knee Stiffness: A Simple and Reproducible Step-by-Step Guide.

Publications

Arthroscopic Lysis of Adhesions and Anterior Interval Release With Manipulation Under Anesthesia for Severe Post-traumatic Knee Stiffness: A Simple and Reproducible Step-by-Step Guide.

Similar Datasets

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