Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty
Vincent Y. Ng1, *, Philip Louie2, Stephanie Punt3, Ernest U. Conrad3
Identifiers and Pagination:Year: 2017
First Page: 45
Last Page: 50
Publisher Id: TOORTHJ-11-45
Article History:Received Date: 21/11/2016
Revision Received Date: 02/01/2017
Acceptance Date: 06/01/2017
Electronic publication date: 24/02/2017
Collection year: 2017
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Severe postoperative knee contractures after arthroplasty or megaprosthesis reconstruction occur rarely, but are devastating complications. Management of preoperative flexion contractures is well-described, but there is a paucity of literature for surgical treatment of postoperative contractures.
A retrospective chart review was performed for a single surgeon of cases between 1996 and 2014.
Nine patients (5 of 66 for pediatrics; 4 of 95 for adults) underwent surgical release for severe stiffness after implantation of knee megaprosthesis. The total arc of motion was improved from a preoperative mean of 34° (range, 10° to 70°) to a postoperative mean 89° (63° to 125°). The amount of extension improved by a mean of 27° (range, -3° to +70°) and the amount of flexion improved by a mean of 28° (range, -10° to +75°).
Surgical release of severe postoperative knee contracture is a challenging procedure, but in most cases, the amount of extension and flexion can be improved, yielding a greater total arc of motion.