Summary
Arthroscopic debridement of scar tissue covered infra patellar fat pad and impinged soft tissue at tibiofemoral joint were performed in thirty knees after total knee arthroplasty. At the follow-up over 12 months, 87% of the cases had improvement of the symptom. We speculated the fibrous band at tibiofemoral joint space should be the cause of unrecognized type of impingement.
Abstract
Introduction
In the cases of painful knee after total knee arthroplasty (TKA), infection, aseptic loosening, arthrofibrosis, patellar clunk syndrome, and patellar synovial hyperplasia had been previously reported. We experienced other type of soft tissue impingement.
Material And Method
Thirty cases who had marked tenderness at tibiofemoral joint space after TKA were candidate for arthroscopic surgery. Infection, aseptic loosening, arthrofibrosis, patellar clunk syndrome, and patellar synovial hyperplasia were excluded from the study by clinical findings. Mean duration from index arthroplasty to arthroscopic surgery was 25 months, and mean duration for follow-up was 24 months (12-67 months)
RESULT
Main arthroscopic finding were fibrous tissue over the infrapatellar fat pad and small fibrous band at femorotibial joint. We removed the fibrous tissue and fibrous band, arthroscopically. In all cases, improvements of the pain were observed at immediately after the surgery. At final follow-up, 87% of the cases had improvement of the symptom.
Discussion
Except for loosening, infection, patellar clunk syndrome, and patellar synovial hyperplasia, there were many cases who had pain after TKA. We speculated that continuity of the solid fibrous tissue over infrapatellar fat pad to fibrous band at tibiofemoral joint space should be the cause of the easy impingement, regardless of size of the impinged tissue. Arthroscopic debridement was useful method for the treatment for painful knee after arthroplasty.