Diagnostic and Therapeutic Arthroscopy in Symptomatic Patients after Knee Arthroplasty

OBJECTIVES Assess the worthiness of arthroscopy in investigating and treating knee pain after arthroplasty unexplained by clinical and subsidiary examinations. METHODS Among 402 patients submitted to total or unicompartimental arthroplasty between September 2001 and April 2007 at a public university hospital, 17 presented with pain on prosthetic articulation, without clear diagnosis by clinical, X-ray, laboratory, scintiscan, or nuclear magnetic resonance tests. All patients were submitted to arthroscopy and symptoms were assessed by using the Lysholm scale, comparing pre-and post-arthroscopy periods. Peroperative findings have been recorded. RESULTS The procedure was effective for pain relief in 14 of 17 patients (82.35%). The median for Lysholm scale climbed from 36 points before arthroscopy to 94 points after the procedure (p < 0.001). Most of the patients (12) were arthroscopically diagnosed with fibrosis known as "cyclop"; on the remaining five patients, anterior synovitis was found. All patients were treated by resection. CONCLUSIONS Knee arthroscopy after arthroplasty in patients presenting unclear persistent pain shows localized arthrofibrosis ("cyclops") or synovitis, which can be treated by using the same procedure, resulting in pain relief.