Surgical Release of Severe Flexion Contracture for Oncologic Knee Arthroplasty

BACKGROUND Severe postoperative knee contractures after arthroplasty or megaprosthesis reconstruction occur rarely, but are devastating complications. Management of preoperative flexion contractures is well-described, but there is a paucity of literature for surgical treatment of postoperative contractures. A retrospective chart review was performed for a single surgeon of cases between 1996 and 2014. RESULTS Nine patients (5 of 66 for pediatrics; 4 of 95 for adults) underwent surgical release for severe stiffness after implantation of knee megaprosthesis. The total arc of motion was improved from a preoperative mean of 34° (range, 10° to 70°) to a postoperative mean 89° (63° to 125°). The amount of extension improved by a mean of 27° (range, -3° to +70°) and the amount of flexion improved by a mean of 28° (range, -10° to +75°). CONCLUSION Surgical release of severe postoperative knee contracture is a challenging procedure, but in most cases, the amount of extension and flexion can be improved, yielding a greater total arc of motion.