- Discussion:
- need to determien whether the fibrous has primarily affected flexion or extension;
- need to determine either from radiographs or from MRI, whether incorrect
tunnel placement, is the cause of the decrease motion and fibrosis;
- also evaluate for
patella baja;
- in some cases, severe patella baja may be associated w/ limited flexion;
- Arthroscopic Treatment:
- adhesions in the suprapatellar pouch and the medial and lateral gutters need
- in the case of correct tunnel placement:
- debride any hypertrophic tissue attached to the graft or tissue that
is impinged between the femur and the tibia;
- frequently, there will be hypertrophic tissue along the anteromedial edge
of the intercondylar notch or along the sides of the tibia tunnel;
- in the case of incorrect tunnel placement:
- determine if additional notchplasty will releive the impingment;
- if the femoral tunnel is too anterior, then consider either revision
ACL reconstruction or possibly graft debridment;
Prevention of arthrofibrosis after anterior cruciate ligament
reconstruction using the central third patellar tendon autograft.
The surgical treatment of arthrofibrosis of the knee.
Outpatient surgical management of arthrofibrosis after anterior cruciate ligament surgery.
Infrapatellar contracture syndrome: An unrecognized cause of knee stiffness w/ patellar entrapment and patella infera.
LE Paulos et al. Am J. Sports Med. Vol 15. 1987. p 331-341.
Arthroscopic Treatment of Flexion Deformity After ACL Reconstruction.
PP Mariani MD, A Ferretti MD, F Conteduca MD, and C Tudisco MD.
Arthroscopy: Vol 8(4): 517-521. 1992.
Graft impingement after ACL reconstruction: presentation as an active extension "thunk".
JG Lane. Am J. Sports Med. Vol 22. p 415. 1994.
Intra-articular fibrous nodule as a cause of loss of extension following anterior cruciate ligament reconstruction.
JM Marzo et al. Arthroscopy. Vol 8. p 10. 1992.
Cyclops syndrome: loss of extension following intra-articular anterior cruciate ligament reconstruction.
DW Jackson and RK Schaefer. Arthroscopy. Vol 6. 171. 1990.
Arthroscopic roofplasty: A method for correcting an extension deficit caused by roof impingement of an anterior cruciate ligament graft.
SM Howell. Arthroscopy. Vol 8. 1992. p 375-379.
