**5. References**


Fig. 12. PCL impingement seen during arthroscopic examination of PCL retaining

by halofuginone. J Biol Chem. 2004; 279:15167-76.

[1] Daumer KM, Khan AU, Steinbeck MJ. Chlorination of pyridinium compounds. Possible

[2] Xavier S, Piek E, Fujii M, Javelaud D, Mauviel A, Flanders KC, Samuni AM, Felici A,

role of hypochlorite, N-chloramines, and chlorine in the oxidation of pyridinoline cross-links of articular cartilage collagen type II during acute inflammation. J Biol

Reiss M, Yarkoni S, Sowers A, Mitchell JB, Roberts AB, Russo A. Amelioration of radiation-induced fibrosis: inhibition of transforming growth factor-beta signaling

prosthesis.

**5. References** 

Chem. 2000; 275:34681-92


Arthroscopy Following Total Knee Replacement 255

[42] Ip D, Wu WC, Tsang WL. Comparison of two total knee prosthesis on the incidence of

[43] Anderson MJ, Becker DL, Kieckbusch T. Patellofemoral complications after posterior-

[44] Lucas TS, DeLuca PF, Nazarian DG, et al. Arthroscopic treatment of patellar clunk. Clin

[45] Clarke HD, Fuchs R, Scuderi GR, et al. The influence of femoral component design in

[46] Lonner J, Jasko J, Bezwada H, et al. Incidence of patellar clunk with a modern posterior-

[47] Maloney WJ, Schmidt R, Sculco TP. Femoral component design and patellar clunk

[48] Yau WP, Wong JWK, Chiu KY, Ng TP, Tang WM. Patellar clunk syndrome after posterior stabilized total knee arthroplasty. J Arthroplasty 2003; 18: 1023–8. [49] Larson CM, Lachiewicz PF. Patellofemoral complications with the Insall– Burstein II posterior-stabilized total knee arthroplasty. J Arthroplasty 1999; 14: 288–92. [50] Sringari T, Maheswaran SS. Patellar clunk syndrome in patellofemoral arthroplasty—a

[51] Vernace JV, Rothman RH, Booth RE. Arthroscopic management of the patellar clunk

[52] Ranawat AS, Ranawat CS, Slamin JE, Slamin JE, Dennis DA. Patellar crepitation in the

[53] Diduch. D, Giles. R. The efficacy of arthroscopy following total knee replacement.

[54] Franz Landsiedl, M.D., Nicolas Aigner. A New Arthroscopic Technique for Revision

[55] Dowson D, Taheri S, Wallbridge N. The role of counterface imperfections in the wear of

[56] Hood RW, Wright TM, Burstein AH. Retrieval analysis of total knee prostheses: a

[57] Levesque M, Livingston BJ, Jones WM, Spector M. Scratches on condyles in normal functioning total knee arthroplasty. Trans Orthop Res Soc. 1998;23:247. [58] Howie DW, Vernon-Roberts B. The synovial response to intraarticular cobaltchrome

[59] Mintz L, Tsao AK, McCrae CR, Stulberg SD, Wright T. The arthroscopic evaluation and

P.F.C. sigma total knee system. Orthopedics 2006; 29: S68–70.

syndrome following posterior stabilized total knee arthroplasty. J Arthroplasty

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 13, No 2

of the Posterior Compartment in Symptomatic Total Knee Arthroplasty; Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 21, No 4

method and its application to 48 total condylar prostheses. J Biomed Mater Res.

characteristics of severe polyethylene wear in total knee arthroplasty. Clin Orthop.

stabilized total knee arthroplasty: a comparison of 2 different implant designs. J

the elimination of patellar clunk in posterior-stabilized total knee arthroplasty. J

patella clunk syndrome. Int Orthop 2002;26:48–51.

stabilized knee design. Am J Orthop 2007; 36: 550.

syndrome. Clin Orthop 2003; 410: 199.

case report. Knee 2005; 12: 456–7.

polyethylene. Wear. 1987; 119:277.

wear particles. Clin Orthop. 1988; 232:244-54.

1989;4:179–82

(April), 1997

(April), 2005

1983;17:829-42.

1991; 273:215-22.

Arthroplasty 2002; 17:422–6.

Orthop 1999; 367:226.

Arthroplasty 2006; 21:167.


[22] Kim DH, Gill TJ, Millett PJ: Arthroscopic treatment of the arthrofibrotic knee.

[23] Millett PJ, Williams RJ III, Wickiewicz TL: Open debridement and soft tissue release as a

[24] Beight JL, Yao B, Hozack WJ, et al: The patellar clunk syndrome after posterior

[25] Hozack WJ, Rothman RH, Booth RE, et al: The patellar clunk syndrome: a complication

[26] Diduch DR, Scudeii GR, Scott WN, et al: The efficacy of arthroscopy following total

[27] Insall JN, Lachiewicz F, Burstein AH: The posterior stabilized condylar design. Two to

[28] Thorpe CD, Bocell JR, Tullos HS: Intra-articular fibrous bands patellar complications

[29] Bocell JR, Thorpe CD, Tullos HS: Arthroscopic treatment of symptomative total knee

[30] Lintner DM, Bocell JR, Tullos HS: Arthroscopic treatment of intraarticular fibrous band

[31] Figgie HE, Goldberg VM, Heiple KG, et al: The Influence of tibial-patellofemoral

[32] Insall JN, Salvati E: Patella position in the normal knee joint. Radiology 101:101,

[33] Okamoto T, Fukani H, Atsui K, Fukunishi S, Koezuka A, Maruo S (2002) Sonographic

[34] Scott RD, Volatile TB (1986) 12 years experience with posterior cruciate retaining total

[35] Sculco TP, Martucci EA (2001) Knee arthroplasty, chapter 6. Patellofemoral joint.

[36] Shoji H, Shimozaki E (1996) Patellar clunk syndrome in total knee arthroplasty without

[37] Vertullo CJ, Easley ME, Scott N, Insall JN (2001) Mobile bearings in primary knee

[38] Callaghan JJ, Insall JN, Greenwald AS (2000) Mobile-bearing knee replacement:

[39] Pollock DC, Ammeen DJ, Engh GA. Synovial entrapment: a complication of posteriorstabilized total knee arthroplasty. J Bone Joint Surg 2002; 84A:2174.

[40] Takahashi M, Miyamoto S, Nagano A. Arthroscopic treatment of soft-tissue

[41] Brassard MF, Insall JN, Scuderi GR. Complications of total knee arthroplasty. In: Insall

impingement under the patella after total knee arthroplasty. Arthroscopy 2002;

JN, Scott WN, editors. Surgery of the Knee. 4th ed. New York: Churchill

location on function of the knee in patients with the posterior stabilized condylar

appearance of fibrous nodules in patellar clunk syndrome: a case report. J Orthop

after total knee arthroplasty. A follow-up note. CORR 309:230, 1994

of posterior stabilized total knee arthroplasty. CORR 241:203, 1989

four year clinical experience. J Bone Joint Surg A 64A: 1317, 1982

after total knee replacement. J Bone Joint Surg A 72A:811, 1990

knee prosthesis. J Bone Joint Surg A 68A:1030, 1986

knee arthroplasty. Clin Orthop 205: 100–107

patella resurfacing. J Arthroplasty 11:198–201

arthroplasty. J Am Acad Orthop Surg 9: 335–364 602

concepts and results. J Bone Joint Surg Am 82:1020–1041

Springer, Berlin Heidelberg New York

stabilized total knee arthroplasty. CORR 299:139, 1994

knee replacement. Arthroscopy 13:166, 1997

arthroplasty. CORR 271:125, 1991

salvage procedure for the severely arthrofibrotic knee. *Am J Sports Med* 1999;27:552-

*Arthroscopy* 2004;20(suppl 2): 187-194.

561

1971

18:E20.

Livingstone; 2006. p. 1752–3.

Sci 7:590–593


**12** 

*USA* 

**Arthroscopic Soft Tissue Releases of the Knee** 

Intra-articular fibrosis, which includes a family of disorders such as anterior interval scarring, posterior capsular contracture, a tight lateral retinaculum, as well as arthrofibrosis, may lead to alterations in joint biomechanics and can result in pain. 1, 2, 3 Specific releases for each region of fibrosis, along with characteristic physical examination findings, have been described. Familiarity with the diagnosis and arthroscopic treatment of these disorders

The anterior interval has been defined as the space between the infrapatellar fat pad and patellar tendon anteriorly, and the anterior border of the tibia and transverse meniscal ligament posteriorly.1 Trauma or previous surgery may cause hemorrhage or inflammation of the fat pad (Hoffa's Syndrome), which may be followed by fibrosis. If fibrosis occurs between the fat pad and transverse ligament or anterior tibia, it will lead to dysfunction of the anterior knee structures, such as decreased excursion of the patellar tendon and result in stretching of the surrounding synovial tissue, which may lead to pain or even loss of knee extension. 1 Fibrosis within the anterior interval can exist on a spectrum of severity. Paulos et al. described infrapatellar contracture syndrome, a severe form of anterior interval

Patients with anterior interval scarring complain of anterior knee pain, and frequently describe a sense of fullness within the knee, especially with extension. Physical examination may demonstrate a small flexion contracture, decreased proximal excursion of the patella, as well as a positive Hoffa's test 1. Hoffa's test is performed by placing the thumb at the margin of the infrapatellar fat pad and patellar tendon medially and laterally with the knee flexed at 30o (Figure 1). Pressure is applied with the thumb, and the knee is fully extended. Increased pain in the fat pad with knee extension indicates a positive result. Patients may also have pain in the fat pad with forceful hyperextension of the knee. The patellar tendon and patella should also be carefully examined to ensure they are not also causes of the

Scarring in the fat pad can be visualized on standard T1- and T2-weighted magnetic resonance imaging (MRI). Low T1- and T2- signal identified on sagittal images coursing from the posterior portion of the fat pad to the anterior surface of the tibia and/or

scarring, with fibrosis of the fat pad and severe limitations in range of motion. 5

transverse meniscal ligament indicates anterior interval scarring.

may lead to improved treatment outcomes in this patient population.

**1. Introduction** 

anterior knee pain.

**2. Anterior interval release** 

**2.1 History and physical examination** 

Michael R. Chen and Jason L. Dragoo

*Stanford University Department of Orthopaedic Surgery,* 

[60] Damage to Cobalt-Chromium Surfaces During Arthroscopy of Total Knee Replacements, Raab, G, Christopher, J, The Journal of Bones and Joint Surgery, Vol 83-A · Number 1 · January 2001
