A mini-invasive procedure for treating arthrofibrosis of the knee

Objective: The aim of this study was to introduce the results of a novel mini-invasive operative technique comprising mini-incision release, “pie-crusting” lengthening of the quadriceps extensor, and arthroscopic lysis in severe arthrofibrotic knees.

Methods: From 2010 to 2014, 17 patients (12 males and 5 females with a mean age of 44 years (range, 19 e62 years)) with severely arthrofibrotic knees were treated with this operative technique. The mean follow-up duration was 23 months. The knee range of motion (ROM) was assessed with a goniometer. The functional outcomes were evaluated according to the Hospital for Special Surgery (HSS) score and Judet's criteria.

Results: The ROM significantly improved from 29.7
(range, 7
e56
) preoperatively to 127
(range, 120
e136
) at the final follow-up in all patients (p < 0.001). According to Judet's criteria, all patients achieved excellent results (ROM > 100
). The HSS score was improved from 70 points (range, 60e85 points) preoperatively to 91 points (range, 84e98 points) (p < 0.001) at the final follow-up. No extension lag, skin necrosis, quadriceps weakness, wound dehiscence or quadriceps tendon rupture occurred.

Conclusions: Mini-invasive quadricepsplasty-associated arthroscopic lysis and manipulation of the knee in flexion is simple and easy and should be considered as a legitimate treatment for arthrofibrosis of the knee.