Xu Huan, Ying Jinhe
The Central Hospital of Lishui City, China.
Acta Orthop Traumatol Turc. 2016 Aug;50(4):424-8. doi: 10.1016/j.aott.2016.06.006. Epub 2016 Jul 15.
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.
From 2010 to 2014, 17 patients (12 males and 5 females with a mean age of 44 years (range, 19-62 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.
The ROM significantly improved from 29.7° (range, 7°-56°) preoperatively to 127° (range, 120°-136°) 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, 60-85 points) preoperatively to 91 points (range, 84-98 points) (p < 0.001) at the final follow-up. No extension lag, skin necrosis, quadriceps weakness, wound dehiscence or quadriceps tendon rupture occurred.
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.
本研究旨在介绍一种新型的微创手术技术的结果，该技术包括小切口松解、股四头肌“馅饼皮样”延长以及对严重关节纤维性强直膝关节进行关节镜下松解。
2010年至2014年，17例严重关节纤维性强直膝关节患者（12例男性，5例女性，平均年龄44岁（范围19 - 62岁））接受了该手术技术治疗。平均随访时间为23个月。使用量角器评估膝关节活动范围（ROM）。根据特殊外科医院（HSS）评分和朱代标准评估功能结果。
所有患者的ROM从术前的29.7°（范围7° - 56°）显著改善至末次随访时的127°（范围120° - 136°）（p < 0.001）。根据朱代标准，所有患者均取得优异结果（ROM>100°）。HSS评分从术前的70分（范围60 - 85分）提高至末次随访时的91分（范围84 - 98分）（p < 0.001）（p < 0.001）。未发生伸直滞后、皮肤坏死、股四头肌无力、伤口裂开或股四头肌腱断裂。
微创股四头肌成形术联合关节镜下膝关节松解及屈膝手法操作简单易行，应被视为膝关节纤维性强直的一种合理治疗方法。
