Results of Judet Quadricepsplasty in Knee Stiffness

Whang, Kuhn Sung; Park, Ki Chul; Kim, Kyung Sik

Abstract

PURPOSE : We performed this study to evaluate the proper indication and complication of the Judet quadricepsplasty in the stiff knee.
MATERIALS AND METHODS
: Authors analyzed 15 cases in 14 patients treated by Judet quadricepsplasty from July 1990 to may 1998. There were 9 male and 5 female with an average age of 32.0 years. The average follow-up was 3 years 7 months. Causes of stiff knee sere femoral distal fracture in 7 cases, femoral midshaft fracture in 5 cases, tuberculosis osteomyelitis in 3 cases. The average interval between injury and quadricepsplasty was 1 year 10 months. We check the preoperative and last follow up range of motion in involved knee, and check the postoperative and last follow up extension lag and complication.
RESULTS
: By the Judet' classification, last follow up results were shown to be 5 cases in excellent, 5 cases in good, 5 cases in poor. Complications were patella fracture in 3 cases, infection in 1 case, femoral artery rupture in 1 case, and these 5 cases were shown to be poor results. Three patella fractures were arisen at the insertion of Quadriceps muscle. Infection was secondary type by the hematoma results from inappropriate hemostasis. Femoral artery rupture was arisen by the severe fibrosis at the surrounding arteries and tissues results from chronic infection due to long term application of Ilizarov apparatus. In the excellent and good results, average preoperative range of motion were 36.0 degrees, average last follow up range of motion were 96..5 degrees, average flexion gain were 60.5 degrees. Postperative extension lag were 16.5 degrees in 7 cases(70%), but last follow up extension lag were 8.7 degrees in 4 cases(40%).
CONCLUSION
: Judet quadricepsplasty was excellent method to solve the extra-articular stiff knee in the proper indication. Inappropriate indication were thought to severe intra-articular adhesion, severe osteoporosis of patella, severe fibrosis in the medial aspect of distal thigh. Postoperative early ROM exercise using CPM were thought to improve the range of motion of involved knee.