2017 ISAKOS Biennial Congress ePoster #1247

 

Continuity of Fibrous Tissue Over Infrapatellar Fat Pad to the Fibrous Band at Tibiofemoral Joint Could be Unrecognized Cause of Soft Tissue Impingement After Total Knee Arthroplasty

Hitoshi Sekiya, MD, Kawachi-Gun, Tochigi JAPAN
Kenzo Takatoku, MD, Kaminokawa-Machi, Tochigi JAPAN
Takashi Fukushima, MD, Shimotsuke, Tochigi JAPAN
Akinori Kimura, MD, Shimotsuke-Shi, Tochigi JAPAN

Shin-Kaminokawa hospital, Kaminokawa-machi, JAPAN

FDA Status Not Applicable

Summary

Arthroscopic debridement of scar tissue covered infra patellar fat pad and impinged soft tissue at tibiofemoral joint were performed in thirty knees after total knee arthroplasty. At the follow-up over 12 months, 87% of the cases had improvement of the symptom. We speculated the fibrous band at tibiofemoral joint space should be the cause of unrecognized type of impingement.

Abstract

Introduction

In the cases of painful knee after total knee arthroplasty (TKA), infection, aseptic loosening, arthrofibrosis, patellar clunk syndrome, and patellar synovial hyperplasia had been previously reported. We experienced other type of soft tissue impingement.

Material And Method

Thirty cases who had marked tenderness at tibiofemoral joint space after TKA were candidate for arthroscopic surgery. Infection, aseptic loosening, arthrofibrosis, patellar clunk syndrome, and patellar synovial hyperplasia were excluded from the study by clinical findings. Mean duration from index arthroplasty to arthroscopic surgery was 25 months, and mean duration for follow-up was 24 months (12-67 months)
RESULT
Main arthroscopic finding were fibrous tissue over the infrapatellar fat pad and small fibrous band at femorotibial joint. We removed the fibrous tissue and fibrous band, arthroscopically. In all cases, improvements of the pain were observed at immediately after the surgery. At final follow-up, 87% of the cases had improvement of the symptom.

Discussion

Except for loosening, infection, patellar clunk syndrome, and patellar synovial hyperplasia, there were many cases who had pain after TKA. We speculated that continuity of the solid fibrous tissue over infrapatellar fat pad to fibrous band at tibiofemoral joint space should be the cause of the easy impingement, regardless of size of the impinged tissue. Arthroscopic debridement was useful method for the treatment for painful knee after arthroplasty.