Rigidez Pós-Artroplastia Total do Joelho

Autores

  • Jorge Andrade Costa Serviço de MFR, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  • Marta Amaral Silva Serviço de MFR, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  • Joana Arcângelo Serviço de Ortopedia, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal
  • Augusto Martins Serviço de Ortopedia, Hospital Curry Cabral, Centro Hospitalar Lisboa Central, Lisboa, Portugal

DOI:

https://doi.org/10.25759/spmfr.200

Palavras-chave:

Amplitude de Movimento Articular, Artroplastia Total do Joelho

Resumo

A artroplastia total do joelho tem por objectivos minimizar a dor, promover a estabilidade articular durante a marcha e maximizar a amplitude de movimento. A prevalência de rigidez pós-artroplastia total do joelho pode atingir os 25%. A comunidade científica aponta, como principais factores de risco para o seu surgimento, uma menor amplitude articular pré-operatória, a pouca colaboração do doente num programa de reabilitação, patela ínfera ou o uso de anticoagulantes cumarínicos. A melhoria do arco de movimento do joelho raramente se verifica após seis meses de artroplastia, mesmo sob um programa de reabilitação adequado. No caso de rigidez pós-operatória, a opção atual mais eficaz para ganho de amplitude inclui a manipulação articular sob anestesia. A artrólise, artroscópica ou aberta, apresenta resultados modestos no ganho de amplitude articular, bem como a artroplastia de revisão. Contudo, a última revela-se eficaz nos casos particulares de rigidez com contratura em flexão.

Downloads

Referências

Artz N, Elvers KT, Sackley C, Jepson P, Beswick AD. Effectiveness of physiotherapy exercise following total knee replacement:

systematic review and meta-analysis. BMC Musculoskelet Disord. 2015; 16:15.

Minns Lowe C, Barker KL, Dewey M, Sackley CM. Effectiveness of physiotherapy exercise after total knee arthroplasty for

osteoarthritis: systematic review and meta-analysis of randomized controlled trials. BMJ. 2007; 1-9.

Bonutti PM, Marulanda GA, McGrath MS, Mont MA, Zywiel MG. Static progressive stretch improves range of motion in

arthrofibrosis following total knee arthroplasty. Knee Surg Sports Traumat Arthrosc. 2010; 18:194-99.

Issa K, Kapadia BH, Kester M, Khanuja HS, Delanois RE, Mont MA. Clinical, objective and functional outcomes of manipulation

under anesthesia to treat total knee stiffness following total knee arthroplasty. J Arthroplasty. 2014; 29:548-52.

Kim J, Nelson CL, Lotke PA. Stiffness after total knee arthroplasty. J Bone Joint Surg Am. 2004; 86A:1479-84.

Yercan HS, Sugun TS, Bussiere C, Ait Si Selmi T, Davies A, Neyret P. Stiffness after total knee arthroplasty: prevalence,

management and outcomes. Knee. 2006; 13:111-7.

Ghandi R, de Beer J, Leone J, Petruccelli D, Winemaker M, Adili A. Predictive risk factors for stiff knees in total knee arthroplasty.

J Arthroplasty. 2006; 21:46-52.

Kahn TL, Schwarzkopf R. Does total knee arthroplasty affect physical activity levels? Datafrom the osteoarthritis initiative. J

Arthroplasty. 2015; 1-5.

Ghani H, Maffulli N, Khanduja V. Management of stiffness following total knee arthroplasty: a systematic review. Knee.

; 19: 751-59.

Hoogeboom TJ, van Meeteren NL, Schank K, Kim RH, Miner T, Stevens-Lapsley JE. Risk factors for delayed inpatient functional

recovery after total knee arthroplasty. Biomed Res Int. 2015; 1-5.

Panni AS, Cerciello S, Vasso M, Tartarone M. Stiffness in total knee arthroplasty. J Orthop Traumatol. 2009; 10:111-18.

Walton NP, Jahromi PJ, Dobson KR, Angel KR, Lewis PL, Campbell DG. Arthrofibrosis following total knee replacement; does

therapeutic warfarin make a difference? Knee.2005; 12:103-6.

Ries MD, Badalamente M. Arthrofibrosis after total knee arthroplasty. Clin Orthop Relat Res. 2000; 177–83.

Della Valle AG, Leali A, Haas S. Etiology and surgical interventions for stiff knee replacements. HSS J. 2007; 3: 182–9.

Weale AE, Murray DW, Newman JH, Ackroyd CE. The length of the patellar tendon after unicompartmental and total knee

replacement. J Bone Joint Surg Br. 1999; 81:790-5.

Brotzman BS, Wilk K. Clinical orthopedic rehabilitation. 2nd ed. Philadelphia:Mosby; 2003.

Zach A, Hendrich S, Pfeifer K. Association between exercise therapy dose and functional improvements in the early

postoperative phase after hip and knee arthroplasty: an observational study. PMR Journal 2015; 1-9.

Fitzsimmons SE, Vazquez EA, Bronson MJ. How to treat the stiff total knee arthroplasty? Clin Orthop Relat Res. 2010; 468: 1096-

Finger E, Willis FB. Dynamic splinting for knee flexion contracture following total knee arthroplasty: a case report.

Cases J. 2008; 1:421.

Edwin PS, Sherwin LS, Gonzalez Della Valle A. Stifness after total knee replacement: how to not repeat surgery. Orthopedics.2010;

:3-4.

Nawghare S, Brooks S. Manipulation under anesthesia for stiffness after total knee replacement: a systematic review. J

Orthop Allied Sci. 2013 1:7-13.

Keating EM, Ritter MA, Harty LD, Haas G, Meding JB, Faris PM,et al. Manipulation after total knee arthroplasty. J Bone Joint Surg

Am. 2007; 89:282-6.

Cates HE, Schmidt JM. Closed manipulation after total knee arthroplasty: outcome and affecting variables. Orthopedics.

; 32:398.

Rubinstein RA Jr, DeHaan A. The incidence and results of manipulation after primary total knee arthroplasty. Knee. 2010;

:29-32.

Sharma V, Maheshwari AV, Tsailas PG, Ranawat AS, Ranawat CS. The results of knee manipulation for stiffness after total knee

arthroplasty with or without an intra articular steroid injection. Indian J Orthop. 2008; 42:314-8.

Heuleu JN, Neyret P. Conduite à tenir devant les raideurs postopératoires du genou. Rev Chir Orthop Reparatice Appar

Mot. 2002; 88:1S27-1S58.

Pariente GM, Lombardi AV, Berend KR, Mallory TH, Adams JB. Manipulation with prolonged epidural analgesia for treatment

of TKA complicated by arthrofibrosis. Surg Technol Int. 2006; 15:221-24.

Shoji H, Yoshino S, Komagamine. Improved range of motion with the Y/S total knee arthoplasty system. Clin Orthop Relat Res.

; 218:150-63.

Fox JL, Poss R. The role of manipulation following total knee replacement. J Bone Joint Surg Am. 1981; 63:357-62.

Bellemans J, Steenwerckx A, Brabants K, Victor J, Laumens J, Fabry G. The judet quadriceplasty: a retrospective analyses of 16

cases. Acta Orthop.1996; 62:2.

Bocell JR, Thorpe CD, Tullos HS. Arthroscopic treatment of symptomatic total knee arthroplasty. Clin Orthop. 1991; 271:125-

Jerosh J, Aldawoudy AM. Arthroscopic treatment of patients with moderate arthrofibrosis after total knee replacement. Knee

Surg Sports Traumatol Arthrosc. 2007; 15:71-7.

Williams RJ Westreich GH, Siegl J, Winsord RE. Arthroscopic release of posterior cruciate ligament for stiff total knee

arthroplasties. Clin Orthop. 1996; 321:185-91.

Babis Gc, Trousdale RT, Pagnano MW, Morrey BF. Poor outcomes of isolated tibíal insert exchange and arthrolysis for the

management of stiffness following total knee arthroplasty. J Bone Joint Surg Am. 2001; 83:1534-6.

Mont MA, Seyler TH, Marulanda GA, Delanois RE, Bhave A. Surgical treatment and customized rehabilitation for stiff knee

arthroplasties. Clin Orthop. 2006; 446:193-200.

Hutchinson JRM, Parish EN, Cross MJ. Results of open arthrolysis for the treatment of stiffness after total knee replacement. J

Bone Joint Surg Br. 2005; 87:1357-60.

Haidukewych GJ, Jacofsky D, Pagnano MW, Trousdale RT. Functional results after revision of well fixed components for

stiffness after primary total knee arthroplasty for stiffness. J Arthroplasty.2005;20:133-8.

Fehring TK, Odum SM, Griffin WL, McCoy TH, Masonis JL, et al. Surgical treatment of flexion contractures after total knee

arthroplasty. J Arthroplasty. 2007; 22:305.

In Y, Kim SJ, Kwon YJ. Patellar tendon lengthening for patella infera using the Ilizarov technique. J Bone Joint Surg Br.

;89:398-400.

Downloads

Como Citar

1.
Andrade Costa J, Amaral Silva M, Arcângelo J, Martins A. Rigidez Pós-Artroplastia Total do Joelho. SPMFR [Internet]. 17 de Janeiro de 2016 [citado 2 de Abril de 2025];27(2):13-8. Disponível em: https://spmfrjournal.org/index.php/spmfr/article/view/200

Edição

Secção

Artigo de Revisão

Artigos Similares

1 2 3 4 5 6 7 8 > >> 

Também poderá iniciar uma pesquisa avançada de similaridade para este artigo.