Arthroscopic Lysis of Adhesions With Adjuvant Radiation for Recalcitrant Knee Arthrofibrosis After Ligament Reconstruction: A Report of Three Cases

TL;DR

This paper reports three cases where a combination of arthroscopic surgery and low-dose radiation improved knee mobility in patients with persistent knee stiffness after ligament surgery.

Contribution

The novel contribution is the successful use of a multistep approach combining revision arthroscopic lysis of adhesions and low-dose irradiation for recalcitrant knee arthrofibrosis.

Findings

All three patients experienced improved range of motion after the combined treatment.

The treatment approach was safe and showed moderate success in challenging cases.

Low-dose irradiation was used at different time intervals after surgery.

Abstract

We report three patients—a 35-year-old female, a 19-year-old female, and a 36-year-old male—who presented with recalcitrant knee arthrofibrosis following anterior cruciate ligament reconstruction (ACLR) and prior lysis of adhesions (LOA). Each patient underwent a multistep treatment approach including revision arthroscopic LOA followed by low-dose irradiation, performed at 26, 8, and 6 months, respectively, after the index procedure. All patients experienced improved range of motion and better outcomes compared to prior interventions. In patients with recalcitrant arthrofibrosis after ACLR who have not responded to standard management, a revision LOA and low-dose irradiation can be safely performed, offering a moderate success rate for the most challenging cases.

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