[Percutaneous arthrolysis under arthroscopic control and manipulation under anesthesia in the treatment of postoperative stiffness of the knee].Rev Chir Orthop Reparatrice Appar Mot. 1988; 74(6):517-25.RC
In the post-operative management of surgery of the knee complicated by stiffness, the results of manipulation under anaesthesia and percutaneous release of adhesions under arthroscopy have been compared in two groups of twenty and twenty-four patients. The two groups were identical in age, 32 years, in the cause, which was ligamentous surgery in 85 per cent and in their level of activity. Arthroscopic release was performed in 90 per cent of cases under continuous peridural anaesthesia whilst manipulations were performed under general anaesthesia in 75 per cent of cases. The mean duration of follow-up was 13 months in arthroscopic releases and 29 months in manipulations. Pre-operative limitation of flexion to 57 degrees in arthroscopic releases and 67 degrees in manipulations under anaesthesia improved to 124 degrees and 134 degrees respectively at the last follow-up. The speed of recovery proved to be twice as rapid in patients with arthroscopic release - 3.2 months compared with 6.1 months for straightforward manipulations. Manipulations under anaesthesia were followed by 6 patello-femoral syndromes (30 per cent) whilst arthroscopic release only had 4 syndromes (18 per cent). Arthroscopic releases and manipulations under anaesthesia made before the end of the third month after operation gave better results than those performed later. However, arthroscopic release can be done very late compared with manipulation under anaesthesia and avoids the need for surgical arthrolysis.