Arthrofibrosis after knee arthroplasty

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Arthrofibrosis after knee endoprosthetics can develop after the implantation of endoprostheses on the knee joint .

Emergence

Arthrofibrosis (abnormal intra-articular increase in connective tissue) develops in around 10% of cases . The patients suffer from pain and an increasing restriction of movement with a lack of extension and flexion, so that the activities of daily living are impaired. The previous treatment with intensive stretching exercises, anesthesia mobilization , scar excision and endoprosthesis replacement often does not lead to the hoped-for success.

Experimental investigations on cell and tissue cultures with fibroblasts have shown that mechanical stress activates these scar-forming cells with increased production of xylosyltransferase. This enzyme is responsible for the physiological scarring, but is also suspected of promoting the fibrosis processes.

treatment

Based on these research results, a new treatment concept for arthrofibrosis was developed that consistently dispenses with passive stretching exercises for the knee joint. The results so far are promising. Operational measures could be prevented. Further controlled, randomized and prospective studies are required.

Individual evidence

  1. ↑ H. Gollwitzer, H. Burgkart, P. Diehl, R. Gradinger, V. Bühren: Therapy of arthrofibrosis after knee joint replacement. In: Orthopedist. 2006; 35, pp. 143-152.
  2. ↑ P. Lobenhoffer, J. Tausendfreund, J. Sign, U. Bosch: Operative therapy of arthrofibrosis. In: Arthroscopy. 1999; 12, pp. 252-259.
  3. ↑ C. Götting, J. Kuhn, K. Kleesiek: Human xylosyltransferase in health and disease. In: Cell Mol Life Sci. 2007; 64, pp. 1498-1517.
  4. ↑ P. Traut: Arthrofibrosis after knee endoprosthetics . In: Forum Sanitas. 01/2012, pp. 8-9. (PDF; 1.6 MB)
  5. ↑ P. Traut: Arthrofibrosis after knee TEP. New knowledge and useful therapeutic measures . In: Orthopedic News. 04/2012, pp. 13-14. (PDF; 375 kB)
  6. ↑ P. Traut: Arthrofibrosis after knee TEP . In: Journal for Physiotherapists. (2012); 64, pp. 62-65. (PDF; 101 kB)