Matsumoto Kazu, Ishimaru Daichi, Sohmiya Kazuki, Terabayashi Nobuo
Department of Orthopedics, Gifu Seiryu Hospital, Gifu, JPN.
Cureus. 2025 Aug 12;17(8):e89923. doi: 10.7759/cureus.89923. eCollection 2025 Aug.
Infrapatellar contracture syndrome (IPCS) is a rare but functionally disabling condition characterized by anterior knee fibrosis and patellotibial impingement. We report the case of a 59-year-old woman who developed IPCS after undergoing tension band wiring for a patellar fracture, presenting with pain, quadriceps weakness, and marked patella baja (Insall-Salvati ratio: 0.377). Proximalization of the tibial tubercle by 15 mm restored patellar height and improved knee flexion from 120° preoperatively to 150° at the one-year follow-up. At two years, the patient achieved full squatting and floor sitting (seiza), with no extension lag, quadriceps strength of 86.4 N (contralateral: 96.6 N), and an improved Timed Up and Go score from 12.89 to 6.86 seconds. Tibial tubercle proximalization may be an effective tendon-sparing option for IPCS with patella baja, enabling restoration of patellar height, improved range of motion, and early rehabilitation without direct tendon manipulation.
髌下挛缩综合征（IPCS）是一种罕见但功能致残的疾病，其特征为膝关节前部纤维化和髌胫撞击。我们报告了一例59岁女性病例，该患者在接受髌骨骨折张力带钢丝固定术后发生IPCS，表现为疼痛、股四头肌无力和明显的髌骨低位（Insall-Salvati比率：0.377）。将胫骨结节近端移位15毫米恢复了髌骨高度，并将膝关节屈曲度从术前的120°改善至随访一年时的150°。两年时，患者能够完全蹲下和坐地板（正坐），无伸直滞后，股四头肌力量为86.4牛（对侧：96.6牛），定时起立行走测试评分从12.89秒提高至6.86秒。对于伴有髌骨低位的IPCS，胫骨结节近端移位可能是一种有效的保留肌腱的选择，能够恢复髌骨高度、改善活动范围并实现早期康复，而无需直接对肌腱进行操作。
