Arthroscopic treatment of intraarticular fibrous bands after total knee arthroplasty : a followup note

Eighteen consecutive patients (average age, 66.4 years at arthroscopy) who had a previous total knee arthroplasty underwent arthroscopic resection of a transverse suprapatellar fibrous band, which was causing patellar snapping and jumping as it impinged on the intercondylar notch portion of the femoral component during active extension (tethered patellar syndrome). Fourteen patients were available for followup at an average of 56 months (range, 37-91 months). All patients had complete relief of the patellar symptoms. One patient had a recurrence of symptoms 10 months after arthroscopy but remained symptom free 30 months after repeat resection. All are currently symptom free and are classified as having excellent results. The average range of motion is 1 degree to 115 degrees. There were no complications attributable to the arthroscopy. The tethered patellar syndrome has been noted by various authors, and has been most commonly treated by arthrotomy. At arthroscopy, a transverse suprapatellar fibrous band was seen to catch on the intercondylar notch of the femoral component, snapping free as the knee extended past approximately 30 degrees. In this population, excellent long-term results were achieved with arthroscopic removal of the transverse suprapatellar band.