Revision Total Knee Arthroplasty for Arthrofibrosis

Abstract Arthrofibrosis is a common issue that can occur after a primary total knee arthroplasty (TKA) and is a significant cause of patient dissatisfaction. As the annual incidence of TKA in the United States rises, the prevalence of arthrofibrosis will rise. The prevalence of this outcome has been reported between 1.3 and 5.3%. The range of values is attributed to the varying quantitative thresholds of flexion and/or extension loss used to define arthrofibrosis. This causes a significant burden on the healthcare system, with a reported 27.5% of the 90-day readmissions after TKA due to arthrofibrosis. This can lead to debilitating results for the affected patients with pain, abnormal gait, fatigue, and difficulty rising from the seated position. The definition of stiffness has changed over the years. This underscores the increasing expectations that both surgeons and patients have for total knee replacements. Management of arthrofibrosis includes both nonoperative and operative modalities. The treatment algorithm includes physical therapy and manipulation under anesthesia (MUA). Physical therapy is most used, while revision arthroplasty is typically reserved as a last resort.