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Ankle fractures
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Oliver Chan, Anthony Sakellariou
Complications following open reduction and internal fixation of ankle fractures are uncommon. A large study looking at over 57000 operated ankle fractures has reported a wound infection rate of 1.4%, symptomatic DVTs between 2–3% and a mortality rate of 1% within 90 days (45). The incidence of superficial peroneal nerve damage is generally underestimated. One study implies that this may be as high as 21% (46). Longer term, the rates of arthrofibrosis are unknown and have not been reliably estimated. With regards to post-traumatic osteoarthritis, the incidence of symptomatic osteoarthritis requiring treatment with ankle arthrodesis or arthroplasty is low (1%) at 5 years (45).
Hip reconstruction osteotomy by Ilizarov method as a salvage option for abnormal hip joints
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Masood Umer, Yasir Mohib, Talal Aqeel Qadri, Haroon Rashid
Knee extension contracture is usually the result of multiple pins being passed through the extensor mechanism, causing pain in flexion of the knee postoperatively. Due to the prolonged duration of treatment, soon enough patients develop adhesions and arthrofibrosis. Some preventive measures to avoid a knee contracture include flexing the knee before application of Ilizarov, as shown earlier; encouraging early range-of-motion exercises; attaching a half-ring near the joint to allow knee bending; gentle handling of tissue during surgery to decrease fibrosis; and preventing infection.
Knee Dislocation
Published in Raymond Anakwe, Scott Middleton, Trauma Vivas for the FRCS (Tr & Orth), 2017
Raymond Anakwe , Scott Middleton
Non-operative management results in a high incidence of recurrent instability, arthrofibrosis and pain, with low outcome scores. In the absence of any contraindications, I would advise repair/reconstruction of the ligamentous injuries performed by a soft tissue knee surgeon with experience in this area.
An algorithmic approach to rehabilitation following arthroscopic surgery for arthrofibrosis of the knee
Published in Physiotherapy Theory and Practice, 2018
Arthrofibrosis is described as an abnormal proliferation of fibrous tissue either intra- or extraarticularly around a joint that can result in motion loss, pain, weakness, swelling, and limited function (Biggs and Shelbourne 2006; Boldt et al. 2004). Sonographic findings include synovial membrane thickening and neovascularity (Boldt et al. 2004). The exact etiology of intra-articular tissue fibrosis is unknown (Chen and Dragoo 2011), but it can occur following knee surgery, trauma, or immobilization (Bonutti et al. 2008), as the inflammatory response can cause fibrosis resulting in restricted knee motion (Chen and Dragoo 2011). This condition most commonly occurs postoperatively, especially following ACLR (Biggs and Shelbourne 2006; Fisher and Shelbourne 1993; Jackson and Schaefer 1990; Klein et al. 1994; Shelbourne, Patel, and Martini, 1996; Shelbourne and Johnson 1994). Risk factors for arthrofibrosis include injury severity, timing of surgery, delayed postoperative rehabilitation, prolonged immobilization, infection, complex regional pain syndrome, and surgical technical errors (Chen and Dragoo 2011). Additional risk factors include: concomitant ligamentous injuries (Marks and Harner 1993); preoperative motion loss (Cosgarea et al. 1994; Shelbourne et al. 1996); and joint swelling and inflammation (Mayr et al. 2004). A greater incidence of arthrofibrosis has been shown to be more common in ACLR with a patellar tendon graft, but this condition can also occur in patients with other graft types (Chang et al. 2003).
Effects of Each Phase of Anterior Cruciate Ligament Reconstruction Surgery on Joint Contracture in Rats
Published in Journal of Investigative Surgery, 2022
Akinori Kaneguchi, Junya Ozawa, Kengo Minamimoto, Kaoru Yamaoka
For patients receiving surgical treatment for joint contracture following ACL reconstruction, the majority of the problem was caused by arthrofibrosis [11]. Arthrofibrosis is characterized by excess proliferation of fibrous tissue in joint components, which is triggered by inflammatory reactions [6,12]. In patients with hemophilia, intraarticular hemorrhage frequently leads to arthrofibrosis via inflammation [13,14]. In animals, blood injections into the joints accelerates immobilization-induced intraarticular adhesion, accompanied by enhanced inflammatory and fibrotic reactions [15]. In addition, a previous study have showed that the formation of blood clots followed by granulation tissue is the main mechanism for joint capsule fibrosis after ACL reconstruction [16].
Tibiofemoral joint mobilizations following total knee arthroplasty and manipulation under anesthesia
Published in Physiotherapy Theory and Practice, 2020
Kathryn Dailey, Michael McMorris, Michael T. Gross
At the fifth patient visit, active left knee flexion had only increased to 65 deg and passive knee flexion was limited to 75 deg. End-range flexion resulted in excessive pain and posttreatment swelling and continued to have a hard end-feel. Concern regarding lack of patient progress was communicated to the orthopedic surgeon. The patient attended her 6-week postoperative visit to the orthopedist 1 week following this communication. A diagnosis of arthrofibrosis was made by the orthopedist and the patient was scheduled for MUA. Her last recorded ROM measurement of the left knee before MUA was 65 deg of active flexion and 80 deg of passive flexion.