Robert Wakolbinger-Habel, Jakob Gaudernak, Brigitte Elisabeth Scheffold, Rainer Fiala, Robert Breuer, Martin Bittner-Frank, Clemens Lang, Helena Zehetner-Nics, Ana Oljaca, Mehdi Mousavi, Tatjana Paternostro-Sluga
{"title":"Conservative treatment of knee arthrofibrosis according to a cellular cytokine-based model : A retrospective pilot evaluation.","authors":"Robert Wakolbinger-Habel, Jakob Gaudernak, Brigitte Elisabeth Scheffold, Rainer Fiala, Robert Breuer, Martin Bittner-Frank, Clemens Lang, Helena Zehetner-Nics, Ana Oljaca, Mehdi Mousavi, Tatjana Paternostro-Sluga","doi":"10.1007/s00508-024-02497-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Arthrofibrosis (AF) is a relatively frequent complication after knee surgery, leading to painful limitation of joint mobility. Currently, intense stretching is performed in many patients, without improvements in mobility. A novel concept, established on a cellular, cytokine-based model, advocates to consider the warning function of pain and to terminate forced joint mobilization to disrupt the cycle of arthrofibrosis. Based on these findings, our clinic developed a comprehensive antifibrotic treatment protocol. The aim of this analysis was to evaluate the patients treated so far.</p><p><strong>Methods: </strong>Patients treated at the Clinic Donaustadt, an academic teaching hospital of the Medical University of Vienna, Austria, according to the clinic's AF protocol, were evaluated by reviewing their records. Patellar mobility, range of motion, tightness, overheat, pain, general mobility, assistive devices, working status and the necessity of additional surgery were assessed at baseline, after 2 months and after 12 months (follow-up).</p><p><strong>Results: </strong>Four patients were treated according to the AF protocol. After two months, patellar mobility and range of motion clearly increased in three out of four patients. At the follow-up examination, patella mobility further increased, extension was complete, flexion at least 120°, and symptoms such as tightness, overheating, nocturnal pain and pain after activity had disappeared in three out of four patients. None of the patients had analgesics or walking aids and three out of four patients had returned to work. Out of the four patients, three expressed high satisfaction with the AF protocol and reported no limitations in daily life, including recreational activities.</p><p><strong>Conclusion: </strong>Based on this pilot evaluation, the comprehensive conservative AF program seems to have high potential. Therefore, larger future studies should be conducted to validate this concept.</p>","PeriodicalId":23861,"journal":{"name":"Wiener Klinische Wochenschrift","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Wiener Klinische Wochenschrift","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00508-024-02497-0","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Arthrofibrosis (AF) is a relatively frequent complication after knee surgery, leading to painful limitation of joint mobility. Currently, intense stretching is performed in many patients, without improvements in mobility. A novel concept, established on a cellular, cytokine-based model, advocates to consider the warning function of pain and to terminate forced joint mobilization to disrupt the cycle of arthrofibrosis. Based on these findings, our clinic developed a comprehensive antifibrotic treatment protocol. The aim of this analysis was to evaluate the patients treated so far.
Methods: Patients treated at the Clinic Donaustadt, an academic teaching hospital of the Medical University of Vienna, Austria, according to the clinic's AF protocol, were evaluated by reviewing their records. Patellar mobility, range of motion, tightness, overheat, pain, general mobility, assistive devices, working status and the necessity of additional surgery were assessed at baseline, after 2 months and after 12 months (follow-up).
Results: Four patients were treated according to the AF protocol. After two months, patellar mobility and range of motion clearly increased in three out of four patients. At the follow-up examination, patella mobility further increased, extension was complete, flexion at least 120°, and symptoms such as tightness, overheating, nocturnal pain and pain after activity had disappeared in three out of four patients. None of the patients had analgesics or walking aids and three out of four patients had returned to work. Out of the four patients, three expressed high satisfaction with the AF protocol and reported no limitations in daily life, including recreational activities.
Conclusion: Based on this pilot evaluation, the comprehensive conservative AF program seems to have high potential. Therefore, larger future studies should be conducted to validate this concept.
期刊介绍：
The Wiener klinische Wochenschrift - The Central European Journal of Medicine - is an international scientific medical journal covering the entire spectrum of clinical medicine and related areas such as ethics in medicine, public health and the history of medicine. In addition to original articles, the Journal features editorials and leading articles on newly emerging topics, review articles, case reports and a broad range of special articles. Experimental material will be considered for publication if it is directly relevant to clinical medicine. The number of international contributions has been steadily increasing. Consequently, the international reputation of the journal has grown in the past several years. Founded in 1888, the Wiener klinische Wochenschrift - The Central European Journal of Medicine - is certainly one of the most prestigious medical journals in the world and takes pride in having been the first publisher of landmarks in medicine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
