RESUMEN
Introduction Restricted range of motion over the knee joint is a known complication following the surgical procedure. Aggressive rehabilitation protocols can initially manage knee stiffness due to arthrofibrosis. If conservative management fails, surgical (open or arthroscopic) release is the preferred modality of management. We present a series of 40 patients with postoperative knee stiffness who were treated with arthroscopic adhesiolysis. Material and methods This is a retrospective study conducted at Phoenix Orthopedic Superspeciality Hospital, Nagpur, India, from 2017 to 2021. Our study included 40 patients with postoperative knee joint stiffness, of whom 27 were males and 13 were females. The study considered the duration of stiffness, which ranged from six months to five years. All patients underwent arthroscopic knee release. A rigorously supervised physical therapy program followed this procedure. Patients were examined at three months, six months, and one year to assess improvement in knee range of movement. Results Out of 40 patients, six were classified as Shelbourne type 4, and the remaining were Shelbourne type 3. Twenty-three of 40 patients developed arthrofibrosis following intra-articular or peri-articular fracture fixation surgery; 11 patients were operated on arthroscopically for anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL) reconstruction. Three patients developed stiffness following total knee replacement, one following patellectomy, and three following infection after fracture fixation. The mean pre-op knee range of motion (ROM) was 48.875 degrees. Following arthroscopic release, the mean improvement in ROM was 60 degrees intra-operatively. The average postoperative range was 108.25 degrees. Conclusion Arthroscopic adhesiolysis and quadriceps release are reliable methods for dealing with postoperative knee stiffness. It prevents wound complications and increases the chances of surgical site infection due to smaller incisions. Postoperatively, we achieved an average increase of 60 degrees in ROM over the knee joint.
RESUMEN
A 38-year-old man without a severe traumatic history reported to the outpatient department (OPD) with wrist pain at the dorsal aspect, mild swelling, stiffness, and restricted mobility at the left wrist joint. The patient had been experiencing these symptoms for a year. There was sharp tenderness, graded as 4 above the lunate bone, on examination of the left wrist joint. Advanced imaging, which is magnetic resonance imaging (MRI), and radiographs suggested that the patient had Kienbock's illness. Typically, the surgical approach for Kienbock's used is wrist fusion or proximal row carpectomy. However, in this case, a novel strategy of bone grafting, scaphoid-capitate fusion, and lunate excision was adopted. This case report explains the outcome of our scaphoid-capitate arthrodesis, which was done to maintain functional mobility and relieve discomfort by halting the progression of carpal collapse and carpal-ulnar translation.