Arthroscopic treatment of peripatellar fibrosis after total knee arthroplasty.

Forty-eight total knee arthroplasties (42 patients) were treated arthroscopically for symptomatic peripatellar fibrosis. All patients complained of knee pain before surgery. In addition, 47 knees (98%) had clicking or clunking, 35 (73%) had difficulty climbing stairs, and 9 (19%) had motion problems. The results of arthroscopy were 20 good (42%), 9 fair (19%), and 19 poor (40%). The mean follow-up time was 32.8 months (range, 11-75 months). A fourth portal was required in 20 knees (17 patients, 42%), indicating the complexity and difficulty of debridement. No components were found to be loose at the time of arthroscopy. A constellation of symptoms are caused by peripatellar fibrosis. In contrast to past reports, the arthroscopic treatment of peripatellar fibrosis was found to be unpredictable. Debridement of the offending soft tissue did not necessarily guarantee a good result. Arthroscopic management of peripatellar fibrosis is recommended; however, limited and specific surgical goals should be established prior to intervention.