Safety and efficacy of the modified Judet quadricepsplasty in patients with post-traumatic knee stiffness
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ORIGINAL ARTICLE
Safety and efficacy of the modified Judet quadricepsplasty in patients with post‑traumatic knee stiffness Fernando Bidolegui1 · Sebastian P. Pereira1 · Robinson E. Pires2 Received: 16 June 2020 / Accepted: 3 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Background Knee stiffness is a challenging complication following complex fractures around the knee. Several treatment strategies have been described in the last decades, but clinical results and complication rates still remain as potential drawbacks. The aim of this study was to access the clinical outcomes and complications of the modified Judet quadricepsplasty following knee stiffness secondary to complex fractures around the knee. Methods A total of 11 patients presenting post-traumatic knee stiffness underwent modified Judet quadricepsplasty from 2014 to 2017. All procedures were performed by the same surgical team, and all patients followed the same postoperative pain control and rehabilitation protocols. No patients underwent medial approach for medial release. When necessary, medial release was performed through the lateral approach. Patients were evaluated using the Judet criteria for final range of motion after 1-year minimum follow-up. Results According to the Judet criteria, 4 patients (36.4%) presented excellent, 6 (54.5%) good, and 1 (9.1%) poor clinical outcomes. Blood transfusion was required in 5 patients (45.4%). No patients presented infection or wound dehiscence. Conclusions Although quadricepsplasty is considered a high morbidity surgical procedure, our favorable functional outcomes with very low complication rates using this modified Judet quadricepsplasty confirmed safety and efficacy of this helpful surgical procedure for the challenge of post-traumatic knee stiffness. Level of evidence Level 4 retrospective case series. Keywords Knee stiffness · Distal femur fractures · Tibial plateau fractures · Judet quadricepsplasty · Floating knee Abbreviations CPM Continuous passive motion ROM Range of motion KSS Knee Society Score
Background With the increase in high-energy trauma, complex fractures around the knee are becoming relatively frequent. Articular congruency, anatomic articular surface restoration, knee alignment, and especially stable fixation are crucial to allow * Robinson E. Pires [email protected] 1
Department of Orthopaedic Surgery, Sirio Libanes Hospital, Buenos Aires, Argentina
Department of the Locomotor Apparatus, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 190, Santa Efegênia, Belo Horizonte, Minas Gerais, Brazil
2
for early rehabilitation and therefore prevent knee stiffness. However, even with using all standard surgical principles of articular fracture fixation, knee stiffness can still occur, thus treatment represents a dilemma. The life quality impact of a stiff knee is extremely high. Normal gait requires full extension and about 70° of knee flexion. Climbing stairs requires about 80° of knee flexion. Around 100° of kne
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