Stiff Knee

Stiff knee is one the most common ailment following any knee surgery.

The stiff knee is traditionally addressed with physiotherapy.

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Stiff knee is a very difficult problem. Stiffness in the knee can result from multiple problems including trauma, surgery , infection , inflammatory conditions etc.

It is a very difficult scenario for a patient. Arthroscopic surgery is boon to the patient in such scenario.

Stiff knee can be due to intraarticular or extraarticular adhesions. Intraarticular adhesions are more common and these are band like structures which form between femur and tibia. Adhesions also form in patellotrochlear joint. A very important feature that is seen is absence of normal patellar mobility. Normally Patella is mobile and can be moved side to side , but in these patients it is not possible to move patella side to side and patella is adhered .

In cases of intraarticular adhesions, Arthroscopic Arthrolysis works well. In some cases in which there is an extraarticular component as well it may be imperative to add extraarticular releases as well .

The classic sequence in intraarticular adhesiolysis is , release of intercondylar adhesions, release of medial Gutter , medial retinacular releases, release of adhesions in suprapatellar pouch, release of lateral gutter , release of lateral patellar retinaculum , Release of adhesions anterior to ACL and PCL, extraarticular release as needed. Occasionally posterior releases may be required.

If a knee is very stiff and physiotherapy is not effective, an arthrolysis surgery can be performed. It can be done both open and arthroscopically.