All-arthroscopic release for treating severe knee extension contractures could improve the knee range of motion and the mid-term functional outcomes

作者：Liu, Ziming; Li, Yuwan; Sun, Pengpeng; Sang, Peng; Zhang, ChengHao; Ren, Youliang; Yang, Jibin; Zhu, Xizhong; Huang, Wei^*; Liu, Yi^*

来源：Knee Surgery, Sports Traumatology, Arthroscopy, 2019, 27(3): 724-730.

DOI：10.1007/s00167-018-5022-3

• Knee extension contractures
• All-arthroscopic release
• Extraarticular adhesion
• Stiffness

PurposeTo evaluate the safety, feasibility, and effectiveness of an all-arthroscopic technique for the intra- and extraarticular release of severe knee extension contractures.MethodsFrom 2012 to 2016, 25 patients with severe knee extension contractures (less than 45 degrees range of flexion) were treated with an all-arthroscopic release technique. The patients underwent intra- and extraarticular arthroscopic release and arthroscopic-assisted mini-incision quadriceps plasty. The post-operative rehabilitation was initiated the first day after the procedures. Comprehensive clinical follow-up evaluations including the range-of-motion (ROM) assessment, the Lysholm score, and the International Knee Documentation Committee (IKDC) score were performed on all patients.ResultsThe median follow-up time was 28months (range 12-65months). The ROM improved from 23.9 degrees 7.5 degrees pre-operatively to 105.9 degrees 6.5 degrees at the final follow-up (P<0.001). In addition, the Lysholm score increased from 59.9 +/- 5.2 pre-operatively to 89.7 +/- 3.3 (P<0.001). The IKDC score increased from 47.6 +/- 3.4 pre-operatively to 91.7 +/- 2.4 (P<0.001). All patients were satisfied with their final ROM and functional outcomes.ConclusionThe all-arthroscopic release technique was a safe, feasible and effective method for treating severe knee extension contractures. The severe knee extension contractures may be successfully addressed by the all-arthroscopic release technique during our clinical practice.Level of evidenceIV.

• 出版日期2019-3
• 单位重庆医科大学