Log in

Irradiation in the treatment of arthrofibrosis after total knee arthroplasty: a preliminary trial

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

Postoperative arthrofibrosis after primary and revision total knee arthroplasty is a severe complication for the affected patient. Several risk factors have been identified for this diagnosis. We present a series of 3 patients with arthrofibrosis after (revision) total knee arthroplasty. Approximately 2 hours before the operative revision procedure, all patients were irradiated once with 7.01 gray. At latest follow-up, all 3 patients showed a distinct improvement of range of motion. Before revision total knee arthroplasty due to arthrofibrosis, a single dose of pre- or postoperative irradiation should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Sharkey PF, Homesley HD, Shastri S, Jacoby SM, Hozack WJ, Rothman RH. Results of revision total knee arthroplasty after exposure of the knee with extensor mechanism tenolysis. J Arthroplasty 19(6): 751–756, 2004

    Article  PubMed  Google Scholar 

  2. Haidukewych GJ, Jacofsky DJ, Pagnano MW, Trousdale RT. Functional results after revision of well-fixed components for stiffness after primary total knee arthroplasty. J Arthroplasty 20(2): 133–138, 2005

    Article  PubMed  Google Scholar 

  3. Lang JE. Clinical outcomes in patients with a history of arthrofibrosis undergoing second primary TKA. AAOS (American Academy of Orthopaedic Surgeons) 2006, Chicago, IL

  4. González della Valle A, Leali A, Haas S. Etiology and surgical interventions for stiff total knee replacements. Published online HSS J 3: 182–189, 2007

    Google Scholar 

  5. Pellegrini jr. VD, Gregoritch SJ. Preoperative irradiation for prevention of heterotopic ossification following total hip arthroplasty. J B Joint Surg, 78:870–881, 1996

    Google Scholar 

  6. Schauwecker J, Pohlig F, Toepfer A, Gollwitzer H, von Eisenhart-Rothe R. Heterotopic ossifications in total hip arthroplasty: prophylaxis and therapy. Orthopade 40(6):500–505, 2011

    Article  PubMed  CAS  Google Scholar 

  7. Baird EO, Kang QK. Prophylaxis of heterotopic ossification — an updated review. J Orthop Surg Res 4: 12, 2009

    Article  PubMed  Google Scholar 

  8. Cooley LM, Goss RJ. The effects of transplantation and x-irradiation on the repair of fractured bones. Am J Anat. 102(2):167–181, 1958

    Article  PubMed  CAS  Google Scholar 

  9. Balboni TA, Gobezie R, Mamon HJ. Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis. Int J Radiat Oncol Biol Phys 65: 1289–1299, 2006

    Article  PubMed  Google Scholar 

  10. Coventry MB, Scanlon PW. The use of radiation to discourage ectopic bone. A nine-year study in surgery about the hip. J Bone Joint Surg Am. 63(2):201–208, 1981

    PubMed  CAS  Google Scholar 

  11. Pfitzner T, Geissler S, Duda G, Perka C, Matziolis G. Increased BMP expression in arthrofibrosis after TKA. Knee Surg Sports Traumatol Arthrosc. Nov 17. [Epub ahead of print] 2011

  12. Watson RS, Gouze E, Levings PP, Bush ML, Kay JD, Jorgensen MS, Dacanay EA, Reith JW, Wright TW, Ghivizzani SC. Gene delivery of TGF-β1 induces arthrofibrosis and chondrometaplasia of synovium in vivo. Lab Invest 90(11):1615–1627. 2010

    Article  PubMed  CAS  Google Scholar 

  13. Zeichen J, Gerich T, Lobenhoffer P, Bosch U. Intrinsic properties of arthrofibrosis tissue: histologic and cell biology analysis. Langenbecks Arch Chir Suppl Kongressbd. 115(Suppl I):189–191, 1998

    PubMed  CAS  Google Scholar 

  14. Oertel S, Schneider U, Keel M, Lütolf UM, Bosshard G. Prophylaxis of heterotopic ossification in patients sedated after polytrauma: medical and ethical considerations. Strahlenther Onkol. 184(4):212–217, 2008

    Article  PubMed  Google Scholar 

  15. Lo TC, Healy WL. Re-Irradiation for prophylaxis of heterotopic ossification after hip surgery. Br J Radiol 74(882): 503–506, 2001

    PubMed  CAS  Google Scholar 

  16. Frikha H, Kochbati L, Daoud J, Ben Romdhane K, Maalej M. Indications for radiotherapy of benign lesions: yesterday, today and tomorrow. Tunis Med 79(12): 647–654, 2001

    PubMed  CAS  Google Scholar 

  17. Schiavone Panni A, Cerciello S, Vasso M, Tartarone M. Stiffness in total knee arthroplasty. J Orthop Traumatol 10(3):111–118, 2009

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Clemens Baier.

About this article

Cite this article

Baier, C., Springorum, HR., Maderbacher, G. et al. Irradiation in the treatment of arthrofibrosis after total knee arthroplasty: a preliminary trial. cent.eur.j.med 7, 553–556 (2012). https://doi.org/10.2478/s11536-012-0009-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-012-0009-9

Keywords

Navigation