Arthroscopic posteromedial capsular release for knee flexion contractures

LaPrade, Robert F.; Pedtke, Andrew; Roethle, Scott

doi:10.1007/s00167-008-0496-z

Cited by 38 publications

(63 citation statements)

References 18 publications

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“…2 Before a posteromedial capsular release is performed, a trial of conservative measures should be attempted, including an aggressive supervised physical therapy regimen and knee bracing. If the extension deficit persists despite these conservative methods, manipulation under anesthesia or an anterior interval release and/or notchplasty and debridement can be performed.…”

Section: Surgical Technique Indicationsmentioning

confidence: 99%

“…Despite a larger incision, this technique has limited visibility, which increases the potential for iatrogenic damage. 2 General advantages of arthroscopic surgery compared with open procedures on the knee include a less invasive nature, decreased operating time, quicker recovery, and decreased postoperative pain. 2 A combined capsular release technique for severe flexion contracture with involved gastrocnemius contracture was proposed by Mariani.…”

Section: Pitfallsmentioning

confidence: 99%

“…2 General advantages of arthroscopic surgery compared with open procedures on the knee include a less invasive nature, decreased operating time, quicker recovery, and decreased postoperative pain. 2 A combined capsular release technique for severe flexion contracture with involved gastrocnemius contracture was proposed by Mariani. 12 In addition to release of the posteromedial capsule, release of the posterolateral capsule and both gastrocnemius tendons was performed in 18 patients.…”

Section: Pitfallsmentioning

confidence: 99%

“…This condition often prevents the patient from fully extending the knee, which is required to perform a normal gait pattern. 1 Both posterior capsular contracture and arthrofibrosis can significantly alter a patient's normal functioning and adversely affect postoperative outcomes, 2 even with a dedicated rehabilitation program. Although multiligament reconstructions of the knee and meniscal transplants have been identified to have the highest incidence of postoperative deficit in knee extension, 3 limitation in knee extension can also be the result of intra-articular pathologies such as adhesion bands, cyclops lesions after anterior cruciate ligament reconstructions, soft-tissue calcifications, and anteriorly placed anterior cruciate ligament tibial reconstruction tunnels or extra-articular causes such as a fibrotic posterior joint capsule.…”

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confidence: 99%

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Arthroscopic Posteromedial Capsular Release

Dean

Chahla

Mikula

et al. 2016

Arthroscopy Techniques

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Post-traumatic or postsurgical flexion contractures of the knee can significantly limit function and lead to gait abnormalities. In this setting, interventions to regain full extension may include bracing, physical therapy, and open or arthroscopic surgery. Open surgical approaches to restore full motion often demand extensive recovery and promote further adhesions and loss of motion, which has led to the advent of arthroscopic techniques to address these pathologies. We present a safe, effective, and reproducible arthroscopic technique for posteromedial capsular release to address knee flexion contractures.

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Section: Surgical Technique Indicationsmentioning

confidence: 99%

Section: Pitfallsmentioning

confidence: 99%

Section: Pitfallsmentioning

confidence: 99%

mentioning

confidence: 99%

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Arthroscopic Posteromedial Capsular Release

Dean

Chahla

Mikula

et al. 2016

Arthroscopy Techniques

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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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