Table II.
Fibrotic patient group clinical details and intraoperative findings.
| Patient | Age (at time of revision) | Comorbidities | Time from primary to revision (years and months) | Clinical history | Rotational profile (CT) | Preoperative ROM (extension-flexion in degrees) | Intraoperative findings | Intraoperative ROM achieved (degrees) | Review date (Years and months post-revision) | Post-op ROM (value add ROM) |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 47 | Mild COPD | 1 Y 9 M | Primary KR 2015, MUA 2016 for restricted ROM, failed, revision 2017 | FCA 0.5°, 2° TCA, 2.5°CR | 0 to 80 | Massive intra-articular fibrosis resected | 0 to 120 | 2 Y | 0 to 90 (10°) |
| 2 | 65 | Nil | 1 Y 1 M | Primary 2016, gradual deterioration in ROM from 0 to 110 post-primary, revision 2017 | FCA 3°, 1° TCA, 3°CR | 30 to 80 | Massive intra-articular fibrosis and synovitis | 0 to 120 | 2 Y | 0 to 105 (55°) |
| 3 | 70 | Type 2 diabetes, asthma, COPD | 3 Y 8 M | Primary 2013, MUA 2014 | FCA 1°, 3° TCA, 4°CR | 30 to 90 | Fibrosis resected particularly from supra- and infrapatella pouch | 0 to 120 | 1 Y 6 M | 10 to 90 (20°) |
| 4 | 65 | Gout | 1 Y 4 M | Primary 2016, MUA 2017, failed to restore ROM | FCA 4°, -1° TCA, 3°CR | 30 to 80 | Massive fibrosis throughout joint | 0 to 120 | 1 Y 9 M | 5 to 85 (30°) |
| 5 | 68 | Nil | 2 Y | Primary 2016, progressive ROM restriction | FCA 0°, 0° TCA, 0°CR | 30 to 60 | Massive resection of scar tissue from intercondylar notch, posteriorly after removal of the PCL and both gutters and from retropatellar tendon | 0 to 130 | 2 Y 1 M | 0 to 80 (50°) |
| 6 | 61 | Hypertension | 1 Y 2 M | Primary 2017, ROM restriction, failed MUA | FCA 0°, 2° TCA, 2°CR | 20 to 80 | Intra-articular fibrosis resected | 0 to 120 | 1 Y 6 M | 5 to 90 (25°) |
| 7 | 65 | Ovarian cancer, asthma, TIA | 1 Y 1 M | Primary 2017, MUA failed 2017, revision 2018 | FCA 4°, -2° TCA,2 °CR | 0 to 40 | dense scar tissue excised from behind the patellar tendon, suprapatellar pouch, both gutters, intercondylar notch, above patella, fat pad and either side of the femoral and tibial components, | 0 to 120 | 2 Y 0 M | 0 to 75 (35°) |
| 8 | 72 | Hypertension, dupuytren’s disease | 1 Y 1 M | Primary 2017 | FCA 0.5°, 1° TCA,1.5 °CR | 20 to 80 | Massive intra-articular fibrosis and scarring, resected | 0 to 120 | 1 Y 9 M | 5 to 95 (30°), has extensor lag |
COPD, chronic obstructive pulmonary disease; CR, combined rotation; FCA, femoral component axis; MUA, manipulation under anaesthesia; ROM, range of movement; TCA, tibial component axis.
Positive values denote external rotation, negative values denote internal rotation.