More Improved Postoperative Range-of-Motion Retention After Arthroscopic Lysis of Adhesions After Total Knee Arthroplasty Is Associated With Arthroscopic Fellowship-Trained Compared With Nonfellowship-Trained Surgeons.

Purpose: To describe whether subspecialty training, specifically arthroscopic fellowship training, influences intraoperative range-of-motion (ROM) gains, postoperative ROM retention, and lysis of adhesions (LOA) complication rates. Methods: Between August 1989 and May 2025, all patients who underwent arthroscopic LOA for stiffness after primary total knee arthroplasty (TKA) at a single multisite academic institution with a minimum follow-up of 3 months were reviewed. Cases were stratified by the surgeon's training: 1 group with arthroscopic fellowship training and another with nonarthroscopic or no fellowship training. Primary outcomes were intraoperative ROM change and postoperative ROM retention compared with intraoperative and pre-TKA baseline values. Revision and periprosthetic joint infection rates were also collected. Results: A total of 94 LOA cases were identified, where 48 (51.1%) were performed by nonarthroscopically trained surgeons. Intraoperative ROM improvements were similar between groups in both knee flexion (35.2° arthroscopic vs 31.1° nonarthroscopic, Conclusions: LOA performed by arthroscopic fellowship-trained surgeons results in significantly better retention of postoperative ROM than nonfellowship-trained surgeons when used for arthrofibrosis after TKA. Level of Evidence: Level III, retrospective comparative study.