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.
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.
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° extension lag.
This mini-invasive operation for the severely arthrofibrotic knee can be
used to increase the range of motion and enhance functional outcome.