Background: To reduce the morbidity of traditional quadricepsplasty
for the treatment of severe arthrofibrosis of the knee, we instituted a
treatment regimen consisting of an initial extra-articular mini-invasive
quadricepsplasty and subsequent intra-articular arthroscopic lysis of
adhesions during the same anesthesia session. The purpose of the present study
was to determine the results of this technique.
Methods: From 1998 to 2001, twenty-two patients with severely
arthrofibrotic knees were managed with this operative technique. The mean age
of the patients at the time of the operation was thirty-seven years. After a
mean duration of follow-up of forty-four months (minimum, twenty-four months),
all patients were evaluated according to the criteria of Judet and The
Hospital for Special Surgery knee-rating system.
Results: The average maximum degree of flexion increased from
27° preoperatively to 115° at the time of the most recent follow-up (p
< 0.001). According to the criteria of Judet, the result was excellent for
sixteen knees, good for five, and fair for one. The average Hospital for
Special Surgery knee score improved from 74 points preoperatively to 94 points
at the time of the most recent follow-up (p < 0.001). A superficial wound
infection occurred in one patient. Only one patient had a persistent 15°
Conclusions: This mini-invasive operation for the severely
arthrofibrotic knee can be used to increase the range of motion and enhance
Level of Evidence: Therapeutic Level IV. See Instructions
to Authors for a complete description of levels of evidence.