The restriction of the range of motion is one of the most frequently encountered complications after the surgical procedures of the knee. While the flexion deficit is relatively well tolerated, even the small extension deficit significantly impairs the quality of life due to the increased stress on the patellofemoral joint, functional leg length discrepancy and the subsequent mechanical overload in the hip joint, lumbar spine and contralateral knee. In the majority of cases the guided physiotherapy protocol is sufficient to restore the full range of motion. In refractory cases, the treatment consists of the thorough arthrolysis of the affected knee, aiming to excise the adhesions, osteophytes and orthopaedic implants interfering with the knee range of motion. However, as the extension deficit persists, the contracture of the knee posterior capsule may develop and the sole debridement of the knee may be insufficient. In such rare cases the treatment consists of the posterior capsulotomy of the affected joint. Traditionally, this procedure was performed through the open approach. However, with the growing indications toward the arthroscopic procedures seen in recent decades, even such salvage procedures like posterior knee capsulotomy are increasingly performed through the arthroscopic approach. The aim of this study is to assess the outcomes of the arthroscopic complete posterior capsulotomy of the knee basing on the knee range of motion and functional outcomes. The primary outcome consists of the knee extension, whereas the secondary outcomes include knee flexion, knee total range of motion, The International Knee Documentation Committee Questionnaire and the Knee injury and Osteoarthritis Outcome Score.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
10
The arthroscopic posterior capsulotomy of the knee is performed according to the predefined surgical technique, which was described in detail in the following publication: Malinowski K, Góralczyk A, Hermanowicz K, LaPrade RF, Więcek R, Domżalski ME. Arthroscopic Complete Posterior Capsulotomy for Knee Flexion Contracture. Arthrosc Tech. 2018 Oct 15;7(11):e1135-e1139. doi: 10.1016/j.eats.2018.07.008. PMID: 30533360; PMCID: PMC6262078.
Artromedical Orthopaedic Clinic
Bełchatów, Poland
RECRUITINGThe extension of the knee
The extension of the knee will be measured with the goniometer with the patient lying supine. The hyperextension of the knee will be denoted as the negative value of knee extension.
Time frame: Immediately after the surgery.
The extension of the knee
The extension of the knee will be measured with the goniometer with the patient lying supine. The hyperextension of the knee will be denoted as the negative value of knee extension.
Time frame: At the 3 month of the follow-up.
The extension of the knee
The extension of the knee will be measured with the goniometer with the patient lying supine. The hyperextension of the knee will be denoted as the negative value of knee extension.
Time frame: At the 6 month of the follow-up.
The extension of the knee
The extension of the knee will be measured with the goniometer with the patient lying supine. The hyperextension of the knee will be denoted as the negative value of knee extension.
Time frame: At the 12 month of the follow-up.
The extension of the knee
The extension of the knee will be measured with the goniometer with the patient lying supine. The hyperextension of the knee will be denoted as the negative value of knee extension.
Time frame: At the 24 month of the follow-up.
The flexion of the knee
The flexion of the knee will be measured with the goniometer with the patient lying supine.
Time frame: Immediately after the surgery
The flexion of the knee
The flexion of the knee will be measured with the goniometer with the patient lying supine.
Time frame: At the 3 month of the follow-up.
The flexion of the knee
The flexion of the knee will be measured with the goniometer with the patient lying supine.
Time frame: At the 6 month of the follow-up.
The flexion of the knee
The flexion of the knee will be measured with the goniometer with the patient lying supine.
Time frame: At the 12 month of the follow-up.
The flexion of the knee
The flexion of the knee will be measured with the goniometer with the patient lying supine.
Time frame: At the 24 month of the follow-up.
The range of motion of the knee
The range of motion of the knee will be measured with the goniometer with the patient lying supine as a difference between knee flexion and knee extension.
Time frame: Immediately after the surgery
The range of motion of the knee
The range of motion of the knee will be measured with the goniometer with the patient lying supine as a difference between knee flexion and knee extension.
Time frame: At the 3 month of the follow-up.
The range of motion of the knee
The range of motion of the knee will be measured with the goniometer with the patient lying supine as a difference between knee flexion and knee extension.
Time frame: At the 6 month of the follow-up.
The range of motion of the knee
The range of motion of the knee will be measured with the goniometer with the patient lying supine as a difference between knee flexion and knee extension.
Time frame: At the 12 month of the follow-up.
The range of motion of the knee
The range of motion of the knee will be measured with the goniometer with the patient lying supine as a difference between knee flexion and knee extension.
Time frame: At the 24 month of the follow-up.
The functional assessment with the International Knee Documentation Committee Questionnaire
Min of 0 max of 87 points, higher scores mean a better outcome
Time frame: Immediately after the surgery.
The functional assessment with the International Knee Documentation Committee Questionnaire
Min of 0 max of 87 points, higher scores mean a better outcome
Time frame: At the 3 month of the follow-up.
The functional assessment with the International Knee Documentation Committee Questionnaire
Min of 0 max of 87 points, higher scores mean a better outcome
Time frame: At the 6 month of the follow-up.
The functional assessment with the International Knee Documentation Committee Questionnaire
Min of 0 max of 87 points, higher scores mean a better outcome
Time frame: At the 12 month of the follow-up.
The functional assessment with the International Knee Documentation Committee Questionnaire
Min of 0 max of 87 points, higher scores mean a better outcome
Time frame: At the 24 month of the follow-up.
The functional assessment with the Knee injury and Osteoarthritis Outcome Score
Min of 0 max of 100 points, higher scores mean a better outcome
Time frame: Immediately after the surgery
The functional assessment with the Knee injury and Osteoarthritis Outcome Score
Min of 0 max of 100 points, higher scores mean a better outcome
Time frame: At the 3 month of the follow-up.
The functional assessment with the Knee injury and Osteoarthritis Outcome Score
Min of 0 max of 100 points, higher scores mean a better outcome
Time frame: At the 6 month of the follow-up.
The functional assessment with the Knee injury and Osteoarthritis Outcome Score
Min of 0 max of 100 points, higher scores mean a better outcome
Time frame: At the 12 month of the follow-up.
The functional assessment with the Knee injury and Osteoarthritis Outcome Score
Min of 0 max of 100 points, higher scores mean a better outcome
Time frame: At the 24 month of the follow-up.
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