A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release

Arthrofibrosis of the knee is a difficult-to-manage complication after meniscoligamentous knee injuries, traumatic injuries with articular extension, and surgeries to treat these conditions. Treatment protocols for the management of postoperative arthrofibrosis exhaust nonoperative therapies before...

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Main Authors: Alexander C. Hayden, M.D., Louis S. Kang, B.S., Adam J. Tagliero, M.D., Mario Hevesi, M.D., Ph.D., Kelechi R. Okoroha, M.D., Bruce A. Levy, M.D., Aaron J. Krych, M.D.
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Arthroscopy Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2212628725002154
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author Alexander C. Hayden, M.D.
Louis S. Kang, B.S.
Adam J. Tagliero, M.D.
Mario Hevesi, M.D., Ph.D.
Kelechi R. Okoroha, M.D.
Bruce A. Levy, M.D.
Aaron J. Krych, M.D.
author_facet Alexander C. Hayden, M.D.
Louis S. Kang, B.S.
Adam J. Tagliero, M.D.
Mario Hevesi, M.D., Ph.D.
Kelechi R. Okoroha, M.D.
Bruce A. Levy, M.D.
Aaron J. Krych, M.D.
author_sort Alexander C. Hayden, M.D.
collection DOAJ
description Arthrofibrosis of the knee is a difficult-to-manage complication after meniscoligamentous knee injuries, traumatic injuries with articular extension, and surgeries to treat these conditions. Treatment protocols for the management of postoperative arthrofibrosis exhaust nonoperative therapies before proceeding to the operating room for lysis of adhesions (LOA). Although LOA restores range of motion in most cases, a recurrence of arthrofibrosis is possible when postoperative therapy protocols are not strictly followed. Limited treatment options exist in the setting of recalcitrant arthrofibrosis. Revision arthroscopic LOA may be performed in this scenario. This revision procedure places neurovascular anatomy in the posterior compartment at risk. Performing a posterior capsule release in the arthroscopic management of recalcitrant arthrofibrosis is challenging but important to optimize recovery of range of motion. This Technical Note and accompanying video present a stepwise approach to LOA that demonstrates a safe method for performing an arthroscopic posterior capsule release in these challenging cases.
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series Arthroscopy Techniques
spelling doaj-art-b0fd71d4bc9349f8b4f44722291d69b62025-08-20T03:40:45ZengElsevierArthroscopy Techniques2212-62872025-07-0114710364610.1016/j.eats.2025.103646A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular ReleaseAlexander C. Hayden, M.D.0Louis S. Kang, B.S.1Adam J. Tagliero, M.D.2Mario Hevesi, M.D., Ph.D.3Kelechi R. Okoroha, M.D.4Bruce A. Levy, M.D.5Aaron J. Krych, M.D.6Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Address correspondence to Aaron J. Krych, M.D., Mayo Clinic, 200 First St. SW, Rochester, MN 55905, U.S.A.; Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A.Arthrofibrosis of the knee is a difficult-to-manage complication after meniscoligamentous knee injuries, traumatic injuries with articular extension, and surgeries to treat these conditions. Treatment protocols for the management of postoperative arthrofibrosis exhaust nonoperative therapies before proceeding to the operating room for lysis of adhesions (LOA). Although LOA restores range of motion in most cases, a recurrence of arthrofibrosis is possible when postoperative therapy protocols are not strictly followed. Limited treatment options exist in the setting of recalcitrant arthrofibrosis. Revision arthroscopic LOA may be performed in this scenario. This revision procedure places neurovascular anatomy in the posterior compartment at risk. Performing a posterior capsule release in the arthroscopic management of recalcitrant arthrofibrosis is challenging but important to optimize recovery of range of motion. This Technical Note and accompanying video present a stepwise approach to LOA that demonstrates a safe method for performing an arthroscopic posterior capsule release in these challenging cases.http://www.sciencedirect.com/science/article/pii/S2212628725002154
spellingShingle Alexander C. Hayden, M.D.
Louis S. Kang, B.S.
Adam J. Tagliero, M.D.
Mario Hevesi, M.D., Ph.D.
Kelechi R. Okoroha, M.D.
Bruce A. Levy, M.D.
Aaron J. Krych, M.D.
A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
Arthroscopy Techniques
title A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
title_full A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
title_fullStr A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
title_full_unstemmed A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
title_short A Stepwise Approach to Arthroscopic Management of Recalcitrant Knee Arthrofibrosis Including Arthroscopic Posterior Capsular Release
title_sort stepwise approach to arthroscopic management of recalcitrant knee arthrofibrosis including arthroscopic posterior capsular release
url http://www.sciencedirect.com/science/article/pii/S2212628725002154
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