Usage of External Fixation in the Treatment of Adult Patients with Knee Joint Stiffness: Review

Abstract

Relevance. Knee contractures have an impact on quality of life and are also a common cause of disability. The use of external fixation devices has a certain place in the treatment of this pathology.Purpose. Using the world literature, to identify the modern position, problems, and prospectives of external fixation in the treatment of knee flexion and extension contractures in adult patients.Methods. EMBASE, Medline, Google Scholar, PubMed, e-LIBRARY, and Cyber resources were used. The analysis included publications relative treatment of knee joint stiffness using external fixation in patients over 18 years old, regardless of gender. At analysis several criterial were used: frame ability to provide movements in the knee joint according with its natural kinematics (biomechanics), stable fixation of the femur and tibia, and possibility inserting wires and halfpins in projection of Reference Positions (RP).Results. The devices used in the treatment of knee joint contractures in adult patients were conditionally divided, depending on the type of hinge, into 4 groups: non-hinged, uniaxial, reproducing, and virtual. It has been established that only orthopedic hexapods, based on virtual hinge, can meet all of the criteria mentioned above. However the technology of any orthopedic hexapod hardware and software usage for the treatment of contractures of the knee joint, was not developed till now.Conclusion. The necessity of developing hex-based technology for treatment patients with knee joint contractures was justified by world literature review. Hexapod hardware must provide possibilities of any inclination angle of any ring, and struts fixation not only to base and mobile rings, but to stabilizing as well. Software should be equipped with multi-total residual option. Ortho-SUV Frame (OSF) meets these requirements.