Clinical Results After Judet Quadricepsplasty for Post-traumatic Knee Stiffness

Istituto Ortopedico Rizzoli

Status: Completed

Conditions: Stiffness of Knee, Not Elsewhere Classified; Knee Fractures

Treatments: Other: Clinical scores; Other: Range of Motion

Study type: Observational

Funder types: Other

Identifiers

NCT06251765

JUD-TR

Details and patient eligibility

About

The Post-traumatic Extension Contracture of the Knee (PECK) is a common complication following knee traumas. It is characterized by a restricted Range of Motion (ROM), pain, and discomfort in the affected knee.

Various factors can cause PECK, primarily inflammation and scar tissue formation. The underlying inflammatory state leads to the development of scar tissue, which - when combined with immobilization - results in the progressive stiffness of the knee. Additionally, prolonged immobilization leads to muscle atrophy and, consequently, reduced mobility and increased rigidity.

All these conditions contribute to a limited ROM, making it challenging to perform various daily activities.

Sometimes conservative treatments can be effective, but surgery is often necessary to restore joint functionality and alleviate pain.

Historically, various surgical approaches have been proposed to address post-traumatic knee stiffness.

Open surgery is typically reserved for cases where arthroscopic adhesion release and manipulation under anesthesia have not been successful. Over the last century, various open surgical techniques have been proposed.

In particular, arthromyolysis according to Judet was first described in the 1950s by the French orthopedic surgeon Jacques Judet. This technique involves a series of incisions and soft tissue releases, allowing the surgeon to resolve the stiffness of the quadriceps tendon caused by trauma or prolonged immobilization.

Although effective in restoring knee joint functionality, arthromyolysis according to Judet is not without risks and potential complications. These include infection, massive bleeding, nerve and muscle-tendon injuries, and residual stiffness.

The purpose of this study is to analyze our case series related to arthromyolysis according to Judet for PECK. Clinical outcomes, complications, and patient satisfaction following this type of intervention will be evaluated.

Enrollment: 20 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Adult patients underwent surgical intervention for arthromyolysis according to Judet with modified surgical technique for knee stiffness from January 2008 to December 2019.
2. Patients with post-traumatic injuries (fractures treated surgically).
3. Patients with a minimum of 4 years of follow-up.
4. Completeness of clinical documentation.

Exclusion criteria

1. Patients who underwent surgical intervention for arthrolysis (both arthroscopic and non-arthroscopic) or arthromyolysis according to Judet with minimally invasive technique.
2. Patients who underwent surgery to address knee stiffness due to other causes (rigid prosthesis, limb lengthening, etc.).
3. Incomplete clinical documentation.

Trial design

20 participants in 1 patient group

Patients

Description:

Patients who underwent Judet arthromyilisis for treatment of post-traumatic knee stiffness

Treatment:

Other: Range of Motion

Other: Clinical scores