Mobilization in anesthesia and arthrolysis in postoperative knee joint stiffness

Knee joint stiffness first of all calls for physiotherapy, ranging from exercise therapy to a passive-immobilization splint. If no progress can be achieved, narcosis mobilization and brisement modéré should be done. If narcosis mobilization does not yield acceptable results, then surgical dissolution and arthrolysis should be performed. Thirty-seven patients with painless fibrous knee-joint stiffness following ligament reconstructions showed a reduction in mobility of 0 degree-20 degrees-80 degrees on average. After narcosis mobilization, full extension and bending could be achieved in 28 patients. In 9 patients, arthrolysis had to be carried out. At follow-up examination 1/2 to 3 1/2 years later, all 37 patients showed an increase in movement of 0 degree-0 degree-125 degrees on average. The "relative gain," the quotient of achieved and possible gain of movement in percentage, ranged from 88% to 96% on average. Other kind of loss of movement, patient age, or sex had no influence on the results. Twenty-six patients were able to participate in sports again due to the increase in movement potential. In the last few years, we have come to prefer arthroscopical arthrolysis instead of surgical arthrolysis when narcosis mobilization fails.