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rehabilitation and arthrofibrosis. It is performed under general or regional anaesthetic to ensure muscle relaxation. 4 , 26 – 32 , 40 – 44 Force is also applied to the patella to free adhesions in the suprapatellar pouch. 8 There is strong evidence to
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stiff knees, with structural disruption of the joint's fibrous connective tissue, originating from inflammation triggered by trauma, surgery or infection. Extracellular matrix proliferation, coupled with the development of adhesions, results in joint
Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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. , the causes of post-traumatic knee stiffness can be divided into flexion contractures, extension contractures, and combined contractures. Post-traumatic stiffness can be due to the presence of dense intra-articular adhesions and/or fibrotic
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formation of adhesions in and around the joint. 10 , 12 , 16 Furthermore, it is well known that lengthened immobilization has a detrimental effect on cartilage quality and thickness. In a study with paraplegics, it was discovered that the cartilage
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and adhesions which contributes to pain and restrictive joint motion. 14 Of TKR patients, 3–10% develop arthrofibrosis after TKR and report pain with activities from < 30% for light manual work to 78% for jumping and pivoting. 15 – 18
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bluntly and continued to the joint line to establish the medial gutter. This is repeated on the lateral side, with the pseudocapsule bluntly dissected, fibrous tissue removed from around the patella and any fibrous adhesions deep to the patella released
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tibia with the release of the deep medial collateral ligament (MCL) to the postero-medial capsule is performed. The superficial MCL may be elevated more distally to extend the medial release. To gain adequate joint exposure, intraarticular adhesions are
Osteoarticular Surgery Research, La Paz Hospital Health Research Institute – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain
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potential for bacterial adhesion with increased activation of leukocytes, which reduces the risk of infection. 100 , 101 Currently, cones are available in several shapes and sizes for both knees, with symmetrical and asymmetrical options that adapt to most
