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The Bone & Joint Journal
Vol. 98-B, Issue 11 | Pages 1479 - 1488
1 Nov 2016
International consensus on the definition and classification of fibrosis of the knee joint
Kalson NS Borthwick LA Mann DA Deehan DJ Lewis P Mann C Mont MA Morgan-Jones R Oussedik S Williams FMK Toms A Argenson JN Bellemans J Bhave A Furnes O Gollwitzer H Haddad FS Hofmann S Krenn V
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Aims

The aim of this consensus was to develop a definition of post-operative fibrosis of the knee.

Patients and Methods

An international panel of experts took part in a formal consensus process composed of a discussion phase and three Delphi rounds.

The Bone & Joint Journal
Vol. 102-B, Issue 10 | Pages 1331 - 1340
3 Oct 2020
Quantification of intra-articular fibrosis in patients with stiff knee arthroplasties using metal-reduction MRI
Attard V Li CY Self A Mann DA Borthwick LA O’Connor P Deehan DJ Kalson NS
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Aims

Stiffness is a common complication after total knee arthroplasty (TKA). Pathogenesis is not understood, treatment options are limited, and diagnosis is challenging. The aim of this study was to investigate if MRI can be used to visualize intra-articular scarring in patients with stiff, painful knee arthroplasties.

Methods

Well-functioning primary TKAs (n = 11), failed non-fibrotic TKAs (n = 5), and patients with a clinical diagnosis of fibrosis1 (n = 8) underwent an MRI scan with advanced metal suppression (Slice Encoding for Metal Artefact Correction, SEMAC) with gadolinium contrast. Fibrotic tissue (low intensity on T1 and T2, low-moderate post-contrast enhancement) was quantified (presence and tissue thickness) in six compartments: supra/infrapatella, medial/lateral gutters, and posterior medial/lateral.

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