الفهرس يوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
Arthrofibrosis of the knee still the most common complication after knee trauma or major surgery. This leads us to investigate the use of arthroscopic arthrolysis and extensive postoperative rehabilitation J. Vernon Luck (60) was the first to use the term arthrofibrosis. He described the loss of range of motion secondary to intraarticular scar tissue formation.The cases of this work were 20 cases.The study was carried out prospectively. All cases encountered during the period of the study were included. In all patients the technique was the 1st attempt to treat the arthrofibrosis, the main operative time was 90 minutes, usually 2 shavers were used. The oldest patient was 60 years old and the youngest 14 years, 15 cases (75%)were from 41- 60 years, the average age for the material was 41 years. Amongue the 20 patients, there were 18male patient (90%) and 2 female patient(10%) with male to female ratio 9:1. The left side was affected in 13 cases (65%) while the right side was affected in only 7 cases (35%) with right to left ratio 1:1.3. ACL reconstruction was responsible for 9 cases (40%) of knee arthrofibrosis in this series, open reduction and internal fixation (ORIF) of distal femur or upper tibia was present 5 (25%) of our cases, one case (5%) was due to Hoffa’s fracture,another case (5%) was occurred after fixation of fracture fixed by retrograde femoral nail, one case (5%) was due to open arthrotomy of the knee joint after septic arthritis knee, the remaining 3 cases (15%) were after reconstruction of multi ligamentus injury of the knee.Workers were the largest group of the patient in these series 14 cases (70%)
followed by 3 cases (15%) were employees.16 cases (80%) were operated upon before 16 weeks of developing limitation of the knee movement, 4 cases (20%) were treated after 16 weeks but before 32 weeks.Only 8 cases (40%) were received intra articular corticosteroid and 12 cases (60%) did not have intra articular corticosteroid.All patients subjected to early aggressive rehabilitation protocols including CPM PROM, low load prolonged stretching (LLPS) exercises, and brace.Patients below 50 years were with the better results than patient over 50 years but the difference was statically insignificant.Cases operated upon during the 1st 16 weeks, were with better functional results than the cases operated after 16 weeks in the overall functional result. Best results were obtained in cases presented after ACL reconstruction, and the worst result obtained in case of post Hoffa’s fracture. Intra articular injection of corticosteroid had no effect on the results. Al l patients subjected to early aggressive physiotherapy protocol, which was the corner stone in keeping range of movement which earned by arthroscopicarthrolysis, and improve the range of movement.