Arthroscopic arthrolysis for ACL knee stiffness

Lorraine underwent an arthroscopic arthrolysis under my care two weeks ago.

When I first met Lorraine back on the 12th of February 2017, she had severe anterior pain with loss of extension following a significant skiing injury which had occurred two to three years previously in the French Alps. She had been very active and really enjoyed her skiing but when she fell she heard a 'snap!' and she was told she had damaged her collateral ligament and the ACL, and also chipped her fibula.

Knee Stiffness after ACL injury

Following this injury she couldn’t extend her knee despite having significant amounts of physiotherapy for six months. She underwent an ACL reconstruction locally, and had an arthroscopic arthrolysis following this and she still couldn’t go straight and had severe posterolateral knee pain. 

She had another arthroscopy to try and settle this down but continued to be unable to extend her knee. The knee was very stiff and although it felt stable, she did have episodes of giving way as well. She limped
when she walked. She struggled on the stairs. She used to be very active and really everything had ground to a halt as a result of this very significant injury.

When I went in at arthroscopy it was interesting that she had a significant fragment of lateral meniscus sitting in the notch and a very tight
notch with the ACL impinging or catching, so I had to release the notch and do a notchplasty and also release part of the ACL and the bone around the notch to get the leg out straight. With a combination of this notchplasty work and also dealing with the torn lateral meniscus, we were able to get the knee virtually straight on the operating table.

I am delighted that Lorraine says that her knee has not felt this good in three years and she is doing so well. Arthroscopic arthrolysis really can play a very powerful role in a stiff knee, even at this late stage.

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