Article

Loss of knee range of motion (ROM) has been reported as
the most common complication following anterior cruciate ligament reconstruction
(ACLR). Arthrofibrosis of the knee, or specifically Cyclops syndrome, has been
described as the formation of a scar tissue nodule adjacent to the tibial tunnel
of the anterior cruciate ligament (ACL) graft. This lesion often results in loss
of knee extension ROM, pain, and impaired function. DESCRIPTION : Three
consecutive patients were referred to physical therapy following arthroscopic
knee surgery for lysis of adhesions of a Cyclops lesion from a previous ACLR.
Arthroscopic debridement was performed between 3 and 12 months post ACLR. An
algorithmic progression of extension ROM was the initial focus of physical
therapy, which then advanced to strengthening, neuromuscular reeducation, and
sport specific training. OUTCOME: Following knee surgery for debridement of the
Cyclops lesion, mean knee joint ROM at the initial physical therapy evaluation
was 7.0 degrees +/- 8.6 degrees to 118.3 degrees +/- 7.6 degrees that progressed
to -1.0 degrees +/- 1.7 degrees to 127 degrees +/- 2.6 degrees at discharge. Mean
numeric pain rating improved from 3.0 +/- 1.0 at the evaluation to 0.7 +/- 1.1 at
discharge. Mean Lower Extremity Functional Scale (LEFS) improved from 56.3 +/-
13.6 to 77.0 +/- 4.3 at discharge. DISCUSSION : Arthroscopic debridement of knee
joint arthrofibrosis after ACLR in conjunction with a postoperative physical
therapy algorithmic approach to maximizing knee joint extension ROM can be
beneficial in gaining symmetrical knee extension range of motion and improved
function. Further studies may help to understand the optimal mode, frequency, and
duration of stretching to achieve full symmetrical knee extension in this population.

Langue : ANGLAIS