Posterior capsulotomy for the treatment of severe flexion contractures of the knee.

Twenty-nine patients (42 knees) with severe flexion contracture of the knee (average 69 degrees) were treated by posterior capsulotomy followed by traction and/or casting. Twenty patients (28 knees) had poliomyelitis. After a follow-up of 21/2 years, 39 knees were corrected to less than 15 degrees of flexion. All of the patients except one were able to ambulate using a knee-ankle-foot orthosis, with or without crutches. Complications included skin necrosis in nine patients, recurrence in six, hypertension in three, and peroneal nerve palsy in one. The rate of complication was less in patients with poliomyelitis. This method is recommended for the treatment of severe flexion contracture of the knee, especially in patients with poliomyelitis, but is not recommended in patients with insensitive skin.