Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients
Purpose: To systematically review the literature and provide a detailed summary of the current treatments and outcomes for arthrofibrosis following knee arthroscopy and anterior cruciate ligament reconstruction (ACLR) and to compare the treatment strategies in pediatric and adult populations. Method...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X24000142 |
| _version_ | 1827270189846102016 |
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| author | Ravali Reddy, B.S. Christopher Bernard, M.D. Armin Tarakemeh, B.A. Tucker Morey, B.S. Mary K. Mulcahey, M.D. Bryan G. Vopat, M.D. Matthew L. Vopat, M.D. |
| author_facet | Ravali Reddy, B.S. Christopher Bernard, M.D. Armin Tarakemeh, B.A. Tucker Morey, B.S. Mary K. Mulcahey, M.D. Bryan G. Vopat, M.D. Matthew L. Vopat, M.D. |
| author_sort | Ravali Reddy, B.S. |
| collection | DOAJ |
| description | Purpose: To systematically review the literature and provide a detailed summary of the current treatments and outcomes for arthrofibrosis following knee arthroscopy and anterior cruciate ligament reconstruction (ACLR) and to compare the treatment strategies in pediatric and adult populations. Methods: A systematic review was performed in March 2022 using PubMed, EMBASE, and Cochrane Library Databases per Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Search terms consisted of variations of the following: (“arthrofibrosis” OR “stiffness” OR “stiff” OR “complications”) AND (“arthroscopy” OR “arthroscop” OR “ACL” OR “anterior cruciate”) AND (“treat” OR “care” OR “management” AND “knee”). The inclusion criteria were studies that were written in English, were published since 2000, and that reported outcomes of knee arthroscopy or ACLR for treatment of arthrofibrosis of the knee. The study quality was assessed, and data about the patients and treatments were recorded. Treatments were compared between pediatric and adult patients. Results: A total of 1,208 articles were identified in the initial search, 42 (3.48%) of which met eligibility criteria, involving treatment regimens for arthrofibrosis following knee arthroscopy or ACLR. Of the 42 studies included, 29 (69.0%) were reported data for adults and 13 (31.0%) reported data for pediatric patients. Thirty-nine studies (92.8%) discussed manipulation under anesthesia and/or lysis of adhesions (LOA) as treatment for arthrofibrosis of the knee, whereas 2 (4.8%) described the use of medications. Conclusions: Within orthopaedic sports medicine literature, there is variability in the reported treatment options for arthrofibrosis of the knee. Most studies identified manipulation under anesthesia and/or LOA as the treatment among both adult and pediatric patients. Other variants include notchplasty, open posterior arthrolysis, total graft resection, removal of hardware with LOA, dynamic splinting, casting in extension, bracing, and medications. Level of Evidence: Level IV, systematic review of Level I-IV studies. |
| first_indexed | 2024-03-07T14:28:14Z |
| format | Article |
| id | doaj.art-a2a50e4f94654bdab6bf51dd13611747 |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2025-03-22T05:17:29Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-a2a50e4f94654bdab6bf51dd136117472024-04-27T04:43:25ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-04-0162100896Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult PatientsRavali Reddy, B.S.0Christopher Bernard, M.D.1Armin Tarakemeh, B.A.2Tucker Morey, B.S.3Mary K. Mulcahey, M.D.4Bryan G. Vopat, M.D.5Matthew L. Vopat, M.D.6University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.; Address correspondence to Tucker Morey, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66103Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.University of Kansas School of Medicine, Kansas City, Kansas, U.S.A.Purpose: To systematically review the literature and provide a detailed summary of the current treatments and outcomes for arthrofibrosis following knee arthroscopy and anterior cruciate ligament reconstruction (ACLR) and to compare the treatment strategies in pediatric and adult populations. Methods: A systematic review was performed in March 2022 using PubMed, EMBASE, and Cochrane Library Databases per Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Search terms consisted of variations of the following: (“arthrofibrosis” OR “stiffness” OR “stiff” OR “complications”) AND (“arthroscopy” OR “arthroscop” OR “ACL” OR “anterior cruciate”) AND (“treat” OR “care” OR “management” AND “knee”). The inclusion criteria were studies that were written in English, were published since 2000, and that reported outcomes of knee arthroscopy or ACLR for treatment of arthrofibrosis of the knee. The study quality was assessed, and data about the patients and treatments were recorded. Treatments were compared between pediatric and adult patients. Results: A total of 1,208 articles were identified in the initial search, 42 (3.48%) of which met eligibility criteria, involving treatment regimens for arthrofibrosis following knee arthroscopy or ACLR. Of the 42 studies included, 29 (69.0%) were reported data for adults and 13 (31.0%) reported data for pediatric patients. Thirty-nine studies (92.8%) discussed manipulation under anesthesia and/or lysis of adhesions (LOA) as treatment for arthrofibrosis of the knee, whereas 2 (4.8%) described the use of medications. Conclusions: Within orthopaedic sports medicine literature, there is variability in the reported treatment options for arthrofibrosis of the knee. Most studies identified manipulation under anesthesia and/or LOA as the treatment among both adult and pediatric patients. Other variants include notchplasty, open posterior arthrolysis, total graft resection, removal of hardware with LOA, dynamic splinting, casting in extension, bracing, and medications. Level of Evidence: Level IV, systematic review of Level I-IV studies.http://www.sciencedirect.com/science/article/pii/S2666061X24000142 |
| spellingShingle | Ravali Reddy, B.S. Christopher Bernard, M.D. Armin Tarakemeh, B.A. Tucker Morey, B.S. Mary K. Mulcahey, M.D. Bryan G. Vopat, M.D. Matthew L. Vopat, M.D. Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients |
| title_full | Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients |
| title_fullStr | Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients |
| title_full_unstemmed | Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients |
| title_short | Manipulation Under Anesthesia and Lysis of Adhesions Are the Most Commonly Reported Treatments for Arthrofibrosis of the Knee After Arthroscopy or Anterior Cruciate Ligament Reconstruction in Both Pediatric and Adult Patients |
| title_sort | manipulation under anesthesia and lysis of adhesions are the most commonly reported treatments for arthrofibrosis of the knee after arthroscopy or anterior cruciate ligament reconstruction in both pediatric and adult patients |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X24000142 |
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