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Bone Joint J. 2016 Nov;98-B(11):1479-1488.

International consensus on the definition and classification of fibrosis of the knee joint.

Author information

1
Newcastle University, NE2 4HH, UK.
2
Newcastle University, Newcastle upon Tyne NE2 4HH, UK.
3
Freeman Hospital, Newcastle Hospitals NHS Trust, High Heaton, Newcastle upon Tyne, NE7 7DN, UK.
4
South Australian Health and Medical Institute, Adelaide, South Australia, Australia.
5
Norfolk and Norwich University NHS Trust, Norwich, UK.
6
Cleveland Clinic , Cleveland, Ohio, USA.
7
University Hospital Llandough, Cardiff, UK.
8
Institute of Sport, Exercise and Health, University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
9
King's College London, St Thomas' Hospital, London SE1 7EH, UK.
10
Royal Devon and Exeter Hospital, Exeter, UK.
11
Sainte-Marguerite Hospital, Aix-Marseille University, Marseille, France.
12
ZOL Hospitals Genk, Belgium.
13
Sinai Hospital, Baltimore, Maryland, USA.
14
University of Bergen, Bergen, Norway.
15
Klinik für Orthopädie und Sportorthopädie, Klinikum rechts der Isar der Technischen Universität, Ismaninger Str. 22, 81675 Munich, Germany.
16
University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
17
LKH Stolzalpe Hospital & Teaching Hospital University Clinic Graz, Austria.
18
MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Germany.

Abstract

AIMS:

The aim of this consensus was to develop a definition of post-operative fibrosis of the knee.

PATIENTS AND METHODS:

An international panel of experts took part in a formal consensus process composed of a discussion phase and three Delphi rounds.

RESULTS:

Post-operative fibrosis of the knee was defined as a limited range of movement (ROM) in flexion and/or extension, that is not attributable to an osseous or prosthetic block to movement from malaligned, malpositioned or incorrectly sized components, metal hardware, ligament reconstruction, infection (septic arthritis), pain, chronic regional pain syndrome (CRPS) or other specific causes, but due to soft-tissue fibrosis that was not present pre-operatively. Limitation of movement was graded as mild, moderate or severe according to the range of flexion (90° to 100°, 70° to 89°, < 70°) or extension deficit (5° to 10°, 11° to 20°, > 20°). Recommended investigations to support the diagnosis and a strategy for its management were also agreed.

CONCLUSION:

The development of standardised, accepted criteria for the diagnosis, classification and grading of the severity of post-operative fibrosis of the knee will facilitate the identification of patients for inclusion in clinical trials, the development of clinical guidelines, and eventually help to inform the management of this difficult condition. Cite this article: Bone Joint J 2016;98-B:1479-88.

KEYWORDS:

Arthroplasty; Fibrosis; Knee

PMID:
27803223
DOI:
10.1302/0301-620X.98B10.37957
[Indexed for MEDLINE]

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