RESEARCH ARTICLE


Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty



Vincent Y. Ng1, *, Philip Louie2, Stephanie Punt3, Ernest U. Conrad3
1 University of Maryland Medical Center - Orthopaedics 110 S. Paca St, 6th Floor, Baltimore, Maryland 21201, United States
2 Rush University - Orthopaedics, Chicago, United States
3 University of Washington - Orthopedics and Sports Medicine 1959 NE Pacific Street , Seattle, Washington 98195, United States


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© 2017 Ng et al.

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.

* Address correspondence to this author at the University of Maryland Medical Center - Orthopaedics 110 S. Paca St, 6th Floor, Baltimore, Maryland 21201, United States, Tel: +443-462-5903; Email: vng@umoa.umm.edu


Abstract

Background:

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.

Results:

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°).

Conclusion:

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.

Keywords: Flexion contracture, Megaprosthesis, Release, Oncologic, Sarcoma, Revision.