Knee extension contracture with fixed anterior tibia subluxation treated with PCL release and quadricepsplasty: a case report

58-year-old male presented with knee extension contracture (25°) with iatrogenic fixed anterior tibial subluxation. Consecutive arthroscopic arthrolysis, manipulation under anesthesia, and quadriceps-Z-plasty during one surgery failed to restore flexion. Therefore, shortened posterior cruciate ligam...

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Bibliographic Details
Published in:Journal of experimental orthopaedics 2023-11, Vol.10 (1), p.125-n/a
Main Authors: Kim, Dong Woon, Mostowy, Marcin, Pękala, Przemyslaw A., Bawor, Michalina, Kennedy, Nicholas I., LaPrade, Robert F., Malinowski, Konrad
Format: Article
Language:English
Subjects:
Case Report
Case reports
Extension contracture
Flexion deficit, fixed anterior tibial subluxation
Fractures
Iatrogenesis
Knee
Ligaments
Magnetic resonance imaging
Medicine
Medicine & Public Health
Orthopedics
Posterior cruciate ligament
Quadricepsplasty
Release
Severe
Surgical Orthopedics
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Description
Summary:58-year-old male presented with knee extension contracture (25°) with iatrogenic fixed anterior tibial subluxation. Consecutive arthroscopic arthrolysis, manipulation under anesthesia, and quadriceps-Z-plasty during one surgery failed to restore flexion. Therefore, shortened posterior cruciate ligament was released, which eliminated subluxation and allowed 115° flexion. Despite physiotherapy, flexion progressively decreased to 70° postoperatively. Revision quadricepsplasty by transverse incisions restored 120° of flexion maintained at 31-months follow-up. International Knee Documentation Committee increased 4/87- > 50/87, Knee injury and Osteoarthritis Outcome 7/100- > 68/100 at follow-up. Posterior cruciate ligament release and repeated quadricepsplasty could be a viable salvage option in severe extension contracture with fixed anterior tibial subluxation.
ISSN:2197-1153
2197-1153
DOI:10.1186/s40634-023-00703-y