Treatment of knee flexion contractures in patients with arthrogryposis

Journal of Pediatric Orthopedics
Harold J P van BosseDebra A Sala

Abstract

Knee flexion contractures in children with arthrogryposis are difficult to treat. The purpose of this study was to assess the effectiveness of posterior knee releases and gradual contracture distraction with an Ilizarov external fixator in correcting and maintaining correction of knee flexion contractures of 40 degrees or greater. The medical records and radiographs of 7 consecutive pediatric patients (10 knees) with arthrogryposis and knee flexion contractures of 40 degrees or greater were reviewed. The mean age at surgery was 7.3 years, and the mean length of follow-up was 52.7 months. All patients' knee flexion contractures were treated with posterior soft tissue releases and an Ilizarov external fixator for gradual contracture distraction. Posterior soft tissue releases included hamstrings lengthenings, proximal gastrocnemius release, and release of posterior capsule. The mean total fixator time was 102 days, with a mean correction rate of 1 degree per day. The mean knee flexion contracture was 72.5 degrees preoperatively, and all knees were corrected to full extension, +/-5 degrees. At latest follow-up, the mean contracture was 20.5 degrees, and all knees were ligamentously stable. The mean total arc of motion was 56 degre...Continue Reading

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Citations

Feb 7, 2012·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Alexander S SpiroRalf Stuecker
Aug 2, 2013·Journal of Children's Orthopaedics·Zaid Al-AubaidiNiels Wisbech Pedersen
Aug 10, 2012·Musculoskeletal Surgery·Manuele LampasiOnofrio Donzelli
Nov 26, 2010·Journal of Pediatric Orthopedics·Alexander S SpiroRalf Stuecker
Nov 26, 2010·Journal of Pediatric Orthopedics·Stephen Su YangReggie C Hamdy
Jan 15, 2009·Clinical Orthopaedics and Related Research·Harold J P van BosseDebra A Sala
Aug 22, 2014·Indian Journal of Orthopaedics·Perajit EamsobhanaEkasame Vanitcharoenkul
Feb 25, 2011·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Gautam AmbegaonkarFrancesco Muntoni
Oct 27, 2015·Journal of Children's Orthopaedics·Eva Pontén
Jul 5, 2015·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·K AyadiH Keskes
Jan 7, 2017·The Journal of Bone and Joint Surgery. American Volume·Harold Jacob Pieter van Bosse, Roger E Saldana
Jul 28, 2019·American Journal of Medical Genetics. Part C, Seminars in Medical Genetics·Marianne GagnonNoémi Dahan-Oliel
Nov 20, 2019·Current Opinion in Pediatrics·Harold J P van Bosse
Aug 24, 2017·Journal of Pediatric Orthopedics·Marcel R WileyCharles E Johnston
Jun 9, 2017·Journal of Pediatric Orthopedics·Harold J P van BosseFatih Durgut
Nov 26, 2020·Journal of Clinical Medicine·Byoung Kyu ParkKun Bo Park
Oct 27, 2020·Journal of Pediatric Rehabilitation Medicine·Delphine Hansen-JaumardNoemi Dahan-Oliel
Apr 22, 2021·Archives of Orthopaedic and Trauma Surgery·Mohamed Y HassaneinNariman Abol Oyoun

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