Role of posterior capsulotomy for the treatment of extension deficits of the knee

Lobenhoffer, H. P.; Bösch, U.; Gerich, T.

doi:10.1007/bf01567970

Cited by 39 publications

(37 citation statements)

References 12 publications

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“…Extension improved to a mean value of 2°in a study by Lobenhoffer et al [11] of 24 patients with an average follow-up of 18 months (range, 6-38 months). In a retrospective review of eight patients by Millett et al [12], loss of extension improved from a preoperative mean of 18.8°-1.25°postoperatively and overall arc of motion improved from a mean of 62.5°-124°.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic posteromedial capsular release for knee flexion contractures

LaPrade

Pedtke

Roethle

2008

Knee Surg Sports Traumatol Arthr

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Extension deficits of the knee can cause functional limitations in patients after knee surgery or injury. Most frequently, they are treated with manipulations, arthroscopic anterior compartment debridements, or open posterior capsular releases once nonoperative treatment fails. However, an arthroscopic posteromedial capsular release to manage flexion deficits has yet to be studied comprehensively. Arthroscopic posteromedial capsular releases of the knee can result in improved knee motion postoperatively. An arthroscopic posteromedial capsular release involves sectioning the posteromedial capsule at its meniscofemoral portion, midway between its femoral attachment and its posterior horn medial meniscus junction. A review of 15 patients who underwent this operation was performed. Passive knee extension and flexion was measured in patients in the supine position using a goniometer at preoperative evaluations, under anesthesia prior to and immediately after the posteromedial capsular release, and at postoperative follow-up evaluations. The average time from the arthroscopic posteromedial capsular release to the final postoperative follow-up was 24.1 months. Preoperative knee extension averaged 14.7 degrees in 15 patients. The average immediate postoperative knee extension averaged -0.9 degrees. At the final postoperative follow-up, knee extension averaged 0.7 degrees. Overall knee motion improved from an average are of motion of 101.6 degrees-129.4 degrees. Arthroscopic posteromedial capsular releases and the concurrent postoperative rehabilitation program were effective in the treatment of knee extension deficits. The encouraging results of this study compare well to data presented in open posterior capsular release studies. We believe that arthroscopic posteromedial capsular releases are an effective means to address symptomatic knee extension deficits.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic posteromedial capsular release for knee flexion contractures

LaPrade

Pedtke

Roethle

2008

Knee Surg Sports Traumatol Arthr

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“…Open [9,[26][27][28] and arthroscopic [19,29] techniques have been described. They will be summarized below.…”

Section: Posterior Arthrolysis For Loss Of Extensionmentioning

confidence: 99%

Post-traumatic knee stiffness: Surgical techniques

Pujol

Boisrenoult

Beaufils

2015

Orthopaedics & Traumatology: Surgery & Research

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Post-traumatic knee stiffness and loss of range of motion is a common complication of injuries to the knee area. The causes of post-traumatic knee stiffness can be divided into flexion contractures, extension contractures, and combined contractures. Post-traumatic stiffness can be due to the presence of dense intra-articular adhesions and/or fibrotic transformation of peri-articular structures. Various open and arthroscopic surgical treatments are possible. A precise diagnosis and understanding of the pathology is mandatory prior to any surgical treatment. Failure is imminent if all pathologies are not addressed correctly. From a general point of view, a flexion contracture is due to posterior adhesions and/or anterior impingement. On the other hand, extension contractures are due to anterior adhesions and/or posterior impingement. This overview will describe the different modern surgical techniques for treating post-traumatic knee stiffness. Any bony impingements must be treated before soft tissue release is performed. Intra-articular stiff knees with a loss of flexion can be treated by an anterior arthroscopic arthrolysis. Extra-articular pathology causing a flexion contracture can be treated by open or endoscopic quadriceps release. Extension contractures can be treated by arthroscopic or open posterior arthrolysis. Postoperative care (analgesia, rehabilitation) is essential to maintaining the range of motion obtained intra-operatively.

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“…Des techniques à ciel ouvert [9,[26][27][28] et arthroscopiques [19,29] ont été décrites. Celle-ci peut s'analyser sur les incidences axiales d'une IRM ou d'un arthroscanner, sur lesquelles on cherchera des adhérences des coques condyliennes postérieures (parfois asymétriques, intéressant une seule coque).…”

Section: Arthrolyse Postérieure Pour Limitation De L'extensionunclassified