Arthroscopic Anterior Circumferential Releases for Arthrofibrosis After Total Knee Arthroplasty

Background

Arthrofibrosis (AF) is a known complication after primary and revision total knee arthroplasty (TKA). Over time, dense scar tissue accumulation leads to debilitating pain and stiffness. For patients who have failed conservative measures, arthroscopic anterior circumferential release has emerged as a promising treatment modality for AF after TKA. Indications: Patients with clinically significant pain and decreased range of motion after primary or revision TKA are the primary indication for arthroscopic anterior circumferential release, which aims to improve knee range of motion that can be maintained through a strict postoperative rehabilitation protocol. Technique Description: To mitigate the risk of damage to the TKA components, portals are established superior to the standard portals while using a wrist arthroscope. Subsequently, anterior debridement is performed to visualize the components, followed by switching to a standard arthroscope to release the medial and lateral gutters. Lastly, the suprapatellar pouch is debrided, and a quadricepsplasty is performed. The patient is prescribed an intensive postoperative rehabilitation protocol that emphasizes early mobilization to prevent recurrence of arthrofibrosis.