ARTHROSCOPY OF SYMPTOMATIC TOTAL KNEE REPLACEMENTS

Between December 1983 and August 1992, 21 knees in 19 patients with sy mptomatic total knee replacements were arthroscopically diagnosed. The average time between total knee replacement and arthroscopy was 20 mo nths (ranging from 4 to 84 months). All patients were primary total kn ee replacements. Metal bars, 5 and 8 mm in diameter and 40 cm in lengt h, were made for arthroscopic treatment of fibroarthrosis. Thirteen kn ees of 11 patients with a diagnosis of arthrofibrosis had an average i mprovement of 42 degrees are of motion 1 year after arthroscopic surge ry. Three knees with an average of 15 degrees increase of motion were determined to be failures. Another two patients had arthroscopic resec tion of fibrous bands with complete relief of patella pain. Among six patients who had revision of total knee replacements after arthroscopi c diagnosis, four had wear in the metal backed patella components, and two had wear in the tibial insert and loosening of cementless patella component. An early diagnosis of implant failure under arthroscopic c ontrol was made, which easily allowed revision of the metal-backed pat ellar button before the development of metallosis and massive osteolys is caused by the marked wear of polyethylene. With the use of our spec ially made metal bars for treating arthrofibrosis, we could release th e adhesion more easily and avoid damage of valuable arthroscopic instr uments.