"Arthrofibrosis remains a rare but potentially devastating complication after ACL reconstruction, and roughly 2 % of patients had post-operative stiffness that required intervention. Female patients are at higher risk of arthrofibrosis. However, when patients develop severe motion complications after ACL injury, interventions are generally effective in preventing permanent arthrofibrosis."
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Procedural intervention for arthrofibrosis after ACL reconstruction: trends over two decades. Sanders TL, Kremers HM, Bryan AJ, Kremers WK, Stuart MJ, Krych AJ. Knee Surg Sports Traumatol Arthrosc. 2017 Feb;25(2):532-537.

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https://www.ncbi.nlm.nih.gov/pubmed/26410093

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Stiffness after total knee replacement - "Various risk factors for stiffness after TKA have been identified, including reduced preoperative knee range of motion, history of prior knee surgery, etiology of arthritis, incorrect positioning or oversizing of components, and incorrect gap balancing. Mechanical and associated causes, such as infection, arthrofibrosis, complex regional pain syndrome, and heterotopic ossification, secondary gain issues have also been identified."
https://www.ncbi.nlm.nih.gov/pubmed/25513992

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"CPM following operative fixation for a fracture of the tibial plateau may reduce the risk of the development of arthrofibrosis, particularly in patients who also undergo prolonged provisional external fixation."

Arthrofibrosis of the knee following a fracture of the tibial plateau. https://www.ncbi.nlm.nih.gov/pubmed/25568423

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"Arthrofibrosis is a potential complication of acute ACL reconstruction. Arthrofibrosis prevents the patient from regaining full range of motion, particularly the terminal 5 degrees of full extension, postoperatively"
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Arthrofibrosis in acute anterior cruciate ligament reconstruction. The effect of timing of reconstruction and rehabilitation.
Shelbourne KD, Wilckens JH, Mollabashy A, DeCarlo M.
Am J Sports Med. 1991 Jul-Aug;19(4):332-6.
PMID: 1897645

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"Revision knee data from six joint arthroplasty centers were compiled for 2010 and 2011' and showed failure from arthrofibrosis of 6.9%.
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Schroer WC, Berend KR, Lombardi AV, Barnes CL, Bolognesi
MP, Berend ME, Ritter MA, Nunley RM (2013) Why are total
knees failing today? Etiology of total knee revision in 2010 and
2011. J Arthroplasty 28(8 Suppl):116–119
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"...arthrofibrosis was categorized into one of four types: Type 1 (25 patients), < 10 degree extension loss and normal flexion; Type 2 (16 patients), > 10 degree extension loss and normal flexion; Type 3 (15 patients), > 10 degree extension loss and > 25 degree flexion loss with a tight patella; and Type 4 (16 patients), > 10 degree extension loss, 30 degrees or more flexion loss, and patella infera with marked patellar tightness."
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Shelbourne KD, Patel DV, Martini DJ (1996) Classification and
management of arthrofibrosis of the knee after anterior cruciate
ligament reconstruction. Am J Sports Med 24(6):857–862
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"In our retrospective study we reviewed 283 patients who were operated on between 1984 and 1993 after an ACL-rupture."......"We saw an overall complication rate of 21.6%. The most common complication was a restricted range of motion in 10.9% which required surgery. In patients treated immediately after injury (within 7 days) we found an arthrofibrosis rate of 17.6%. In delayed surgery (more than 4 weeks after injury) this complication was only seen in 6.1%."
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[Complications in 283 cruciate ligament replacement operations with free patellar tendon transplantation. Modification by surgical technique and surgery timing]. [Article in German]
Passler JM1, Schippinger G, Schweighofer F, Fellinger M, Seibert FJ. Unfallchirurgie. 1995 Oct;21(5):240-6. ----

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"Excellent clinical results can be achieved after ACL reconstructions performed soon after injury using autograft hamstrings. Although the authors do not advocate that all reconstructions should be performed acutely, they found that early ACL reconstructions do not result in loss of motion or suboptimal clinical results as long as a rehabilitation protocol emphasizing extension and early range of motion is employed."
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Postoperative range of motion following anterior cruciate ligament reconstruction using autograft hamstrings: a prospective, randomized clinical trial of early versus delayed reconstructions. Bottoni CR1, Liddell TR, Trainor TJ, Freccero DM, Lindell KK.Am J Sports Med. 2008 Apr;36(4):656-62. doi: 10.1177/0363546507312164.
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"graft failure can have a biologic cause rather than a mechanical one "
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Post-operative problems following anterior cruciate ligament reconstruction. Almekinders LC1, Moore T, Freedman D, Taft TN.Knee Surg Sports Traumatol Arthrosc. 1995;3(2):78-82. ----
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