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A less invasive procedure for posttraumatic knee stiffness

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Management of posttraumatic knee stiffness (PTKS) is among the most difficult challenges in postoperative rehabilitation.

Aim

The purpose of this retrospective study was to present the outcomes of a procedure for PTKS. In this study, a less invasive procedure was introduced, which included intra-articular arthroscopic release, extra-articular mini-incision release and “multiple Z” lengthening of the knee extensor, as well as an early, aggressive rehabilitation protocol.

Patients

A series of patients aged from 29 to 60 years were treated with this procedure from April 2005 to May 2009, and the mean duration of follow-up was 13.5 months.

Results

The range of motion increased significantly in all patients. Flexion improved from a mean of 51° preoperation to a mean of 100° at discharge, and the average extension loss improved from 10° to 3° (p < 0.000). The average knee score, according to the Hospital for Special Surgery system, improved from 62 points preoperatively to 77 points at discharge, and 91 points at final follow-up (p < 0.000). All the patients were satisfied with the final ROM gain.

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References

  1. Cole PA, Ehrlich MG (1997) Management of the completely stiff pediatric knee. J Pediatr Orthop 17:67–73

    Article  PubMed  CAS  Google Scholar 

  2. Lindenfeld TN, Wojtys EM, Husain A (2000) Operative treatment of arthrofibrosis of the knee. Instr Course Lect 49:211–221

    PubMed  CAS  Google Scholar 

  3. Noyes FR, Mangine RE, Barber SD (1992) The early treatment of motion complications after reconstruction of the ACL. Clin Orthop 277:217–228

    PubMed  Google Scholar 

  4. Sprague NF, O’Connor RL, Fox JM (1982) Arthroscopic treatment of postoperative knee fibroarthrosis. Clin Orthop 166:165–172

    PubMed  Google Scholar 

  5. Thompson TC (1944) Quadricepsplasty to improve knee function. J Bone Joint Surg 26:366–379

    Google Scholar 

  6. Judet R (1959) Mobilization of the stiff knee. J Bone Joint Surg 41B:856–857

    Google Scholar 

  7. Hahn SB, Lee WS, Han DY (2000) A modified Thompson quadricepsplasty for the stiff knee. J Bone Joint Surg 82B:992–995

    Article  Google Scholar 

  8. Insall JN, Ranawat CS, Agiletti P et al (1976) A comparison of four models of total knee-replacement prostheses. J Bone Joint Surg 58A:754–765

    Google Scholar 

  9. Blauth W, Jaeger T (1990) Arthrolysis of the knee joint. Orthopade 19:388–399

    PubMed  CAS  Google Scholar 

  10. Nicoll EA (1963) Quadricepsplasty. J Bone Joint Surg 45B:483–490

    Google Scholar 

  11. Ali AM, Villafuerte J, Hashmi M et al (2003) Judet’s quadricepsplasty, surgical technique and results in limb reconstruction. Clin Orthop 415:214–220

    Article  PubMed  Google Scholar 

  12. Bellemans J, Steenwerckx A, Brabants K et al (1996) The Judet quadricepsplasty: a retrospective analysis of 16 cases. Acta Orthop Belg 62:79–82

    PubMed  CAS  Google Scholar 

  13. Millett PJ, Williams RJ, Wickiewicz TL (1999) Open debridement and soft tissue releases as a salvage procedure for the severely arthrofibrotic knee. Am J Sport Med 27:552–560

    CAS  Google Scholar 

  14. Jovanovic S, Orlie D, Wertheimer B et al (2000) Quadricepsplasty after war fracture. Mil Med 165:263–267

    PubMed  CAS  Google Scholar 

  15. Moore TJ, Harwin C, Green SA et al (1987) The results of quadricepsplasty on knee motion following femoral fractures. J Trauma 27:49–51

    Article  PubMed  CAS  Google Scholar 

  16. Pick RY (1976) Quadricepsplasty: a review, case presentation, and discussion. Clin Orthop 120:138–142

    PubMed  Google Scholar 

  17. Conti V (1979) Arthroscopy in rehabilitation. Orthop Clin North Am 10:709–711

    PubMed  CAS  Google Scholar 

  18. Parisien JS (1988) The role of arthroscopy in the treatment of postoperative fibroarthrosis of the knee joint. Clin Orthop 229:185–192

    PubMed  Google Scholar 

  19. Rodriguez Blanco CE, Leon HO, Guthrie TB (2001) Endoscopic quadricepsplasty: a new surgical technique. Arthroscopy 17:504–509

    Article  Google Scholar 

  20. Steinfeld R, Torchia ME (1998) Arthroscopically assisted percutaneous quadricepsplasty: a case report and description of a new technique. Arthroscopy 14:212–214

    Article  PubMed  CAS  Google Scholar 

  21. Dhillon MS, Panday AK, Aggarwal S et al (2005) Estra articular arthroscopic release in post-traumatic stiff knees: a prospective study of endoscopic quadriceps and patellar release. Acta Orthop Belg 71:197–203

    PubMed  Google Scholar 

  22. Wang JJ, Zhao JZ, He YH (2006) A new treatment strategy for severe arthrofibrosis of the knee. J Bone Joint Surg 88A:1245–1250

    Article  Google Scholar 

  23. Behrend H, Hertel P (2003) Results of the surgical treatment of arthro-fibrosis of the knee. Unfallchirurg 106(6):483–491

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics and Rehabilitation, Beijing Charity Hospital, Feng Tai District, Jiao Men Bei Road #10, Beijing, 100068, People’s Republic of China

    Ke-min Liu, Sihai Liu, Zhigang Cui, Xinzuo Han, Tao Tang & Anqin Wang

  2. School of Rehabilitation Medicine, Capital Medical University, Beijing, Peoples Republic of China

    Ke-min Liu, Sihai Liu, Zhigang Cui, Xinzuo Han, Tao Tang & Anqin Wang

Authors
  1. Ke-min Liu
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  2. Sihai Liu
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  3. Zhigang Cui
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  4. Xinzuo Han
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  5. Tao Tang
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  6. Anqin Wang
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Corresponding author

Correspondence to Ke-min Liu.

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Liu, Km., Liu, S., Cui, Z. et al. A less invasive procedure for posttraumatic knee stiffness. Arch Orthop Trauma Surg 131, 797–802 (2011). https://doi.org/10.1007/s00402-010-1223-z

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  • DOI: https://doi.org/10.1007/s00402-010-1223-z

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