Patellar Base Support Technique During Manipulation Under Anesthesia for Knee Arthrofibrosis Limits the Risk of Iatrogenic Complications

Knee extension contracture is a common postinjury and postsurgical complication, which decreases knee joint flexion. Many techniques have been described in the literature to restore knee flexion, with the most common one being an arthroscopic lysis of adhesions. However, in severe cases, additional...

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Published inArthroscopy techniques (Amsterdam) Vol. 12; no. 12; pp. e2321 - e2327
Main Authors Malinowski, Konrad, Mostowy, Marcin, Kanak, Michał, Pękala, Przemysław A, Kim, Dong Woon, Kennedy, Nicholas I, LaPrade, Robert F
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier 01.12.2023
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Technical Note
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Summary:Knee extension contracture is a common postinjury and postsurgical complication, which decreases knee joint flexion. Many techniques have been described in the literature to restore knee flexion, with the most common one being an arthroscopic lysis of adhesions. However, in severe cases, additional intra- and extra-articular procedures are needed to restore full knee flexion. Manipulation under anesthesia (MUA) is one of them. Unfortunately, it may lead to devastating complications, such as iatrogenic rupture of the patellar tendon or fractures of the patella or tibial tuberosity. Therefore, the purpose of this report is to present a safer modification of MUA for knee extension contracture in cases in which excessive force is demanded to achieve flexion. The key aim of the "patellar base support" technique (PBS technique) is to stretch the contracted quadriceps muscle with controlled and decreased tension on the patella, patellar tendon, and tibial tuberosity.
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ISSN:2212-6287
2212-6287
DOI:10.1016/j.eats.2023.08.001