Modified Thompson quadricepsplasty to treat extension contracture of the knee after surgical treatment of patellar fractures.

BACKGROUND This retrospective study reported on the treatment of extension contracture of the knee after surgical treatment of patellar fractures. METHODS Twenty-eight patients who sustained extension contractures of the knee after surgical treatment of patellar fractures 8-14 months previously (mean, 12 months) were treated. A midline longitudinal approach was made. After implants were removed, adhesions between the vastus intermedius and the femur, and in the patellofemoral joint were released completely. The knee was flexed up to 110 degrees. Postoperatively, a continuous passive motion (CPM) machine was used to assist knee flexion. Physical therapy was continued at local clinics. No aids were necessary for ambulation. RESULTS Twenty-four patients were followed-up for at least 2 years (range, 2.1-7.6 years; mean, 4.6 years). The mean arc of motion of the knee improved from 72 degrees preoperatively to 123 degrees (p < 0.001). Knee function improved from an unsatisfactory grade in all 24 patients preoperatively to a satisfactory grade in 21 patients (p < 0.001). There were no significant surgical complications. CONCLUSION This surgical technique has a high success rate with few complications. Above all, the surgical procedure is relatively simple. Therefore, it can be considered for indicated cases.