Arthrofibrosis from ACL Injuries



- Discussion:
    - need to determien whether the fibrous has primarily affected flexion or extension;
    - need to determine either from radiographs or from MRI, whether incorrecttunnel placement, is the cause of the decrease motion and 
           fibrosis;
    - also evaluate for patella baja;
           - in some cases, severe patella baja may be associated w/ limited flexion;

- Arthroscopic Treatment:
    - adhesions in the suprapatellar pouch and the medial and lateral gutters need
    - in the case of correct tunnel placement:
           - debride any hypertrophic tissue attached to the graft or tissue that is impinged between the femur and the tibia;
           - frequently, there will be hypertrophic tissue along the anteromedial edge of the intercondylar notch or along the sides of the tibia 
                  tunnel;
    -  in the case of incorrect tunnel placement:
           - determine if additional notchplasty will releive the impingment;
           - if the femoral tunnel is too anterior, then consider either revision ACL reconstruction or possibly graft debridment



Prevention of arthrofibrosis after anterior cruciate ligament reconstruction using the central third patellar tendon autograft.

The surgical treatment of arthrofibrosis of the knee.

Outpatient surgical management of arthrofibrosis after anterior cruciate ligament surgery.

Infrapatellar contracture syndrome:  An unrecognized cause of knee stiffness with patellar entrapment and patella infera.

Arthroscopic Treatment of Flexion Deformity After ACL Reconstruction.

Graft impingement after ACL reconstruction: presentation as an active extension "thunk".

Intraarticular fibrous nodule as a cause of loss of extension following anterior cruciate ligament reconstruction.

Cyclops syndrome: loss of extension following intra-articular anterior cruciate ligament reconstruction.
  
Arthroscopic roofplasty: A method for correcting an extension deficit caused by roof impingement of an anterior cruciate ligament graft.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, May 1, 2012 4:51 pm