SOFT TISSUE PROCEDURE: QUADRICEPSPLASTY FOR POST OPERATIVE STIFF KNEE
Post-traumatic knee stiffness and loss of range of motion is a common complication of injury/ surgery around the knee area. Post-traumatic knee stiffness can be due to the presence of dense adhesion within the joint. Fibrotic transformation of surrounding structures e.g. muscles, fascia, skin. Depending on the nature of the initial injury and the treatments applied. These two components will be present in variable amounts in a stiff knee.
A precise diagnosis and understanding of the pathology is mandatory prior to any surgical treatment. Various open and arthroscopic surgical treatments are possible.
Knee Stiffness Case
Presented here is a young man, carpenter by profession. Who had sustained a fracture of lower part of left thigh and was operated elsewhere. The surgical scar was just above the knee. Few years later, he opted for implant removal by same surgeon. However unfortunately this time he didn’t go for knee rehabilitation. And so didn’t do knee exercises. He presented to us with a stiff knee with range of motion only up to 90⁰ flexion. This poor range is interfering in his work as a carpenter wherein he have to squat frequently. The surgical scar had become adherent to the underlying tissues. Although it nicely healed without infection.
The patient is take to operation theatre and evaluated under anesthesia. Under anesthesia too, the range of knee movement remained the same. At the outset, arthroscopy- key hole examination of knee joint is perform. To rule out and manage and intra-articular adhesions. Thenceforth, the adherent scar tissue is excise and the underlying fascia. And muscle mass freed from adhesions to bone. We were able to achieve complete knee bending on table, as shown in picture. The patient was put on aggressive post op rehabilitation and analgesia. He has been able to successfully maintain a good range after surgery.