This article is part of a special collection:  Volume 101, Issue 1, Supplement– selected
pp. S1-S186 (February 2015)  2014 Instructional Course Lectures (SoFCOT)

N Pujol, P Boisrenoult, P Beaufils – Orthopaedics & Traumatology: Surgery & …,

2015

N Pujol, P Boisrenoult, P Beaufils – Orthopaedics & Traumatology: Surgery & …, 2015

… Moreover, any complexregionalpainsyndrome (CRPS) must be detected. … The signs of CRPS
(warm, inflamed knee; pain that is not relieved by analgesics; stiffness that persists or gets worse)
are in direct contrast … The more chronic the injury, the less the previous rules apply. …

Abstract

Post-traumatic knee stiffness and loss of range of motion is a common complication of injuries to the knee area. The causes of post-traumatic knee stiffness can be divided into flexion contractures, extension contractures, and combined contractures. Post-traumatic stiffness can be due to the presence of dense intra-articular adhesions and/or fibrotic transformation of peri-articular structures. Various open and arthroscopic surgical treatments are possible. A precise diagnosis and understanding of the pathology is mandatory prior to any surgical treatment. Failure is imminent if all pathologies are not addressed correctly. From a general point of view, a flexion contracture is due to posterior adhesions and/or anterior impingement. On the other hand, extension contractures are due to anterior adhesions and/or posterior impingement. This overview will describe the different modern surgical techniques for treating post-traumatic knee stiffness. Any bony impingements must be treated before soft tissue release is performed. Intra-articular stiff knees with a loss of flexion can be treated by an anterior arthroscopic arthrolysis. Extra-articular pathology causing a flexion contracture can be treated by open or endoscopic quadriceps release. Extension contractures can be treated by arthroscopic or open posterior arthrolysis. Postoperative care (analgesia, rehabilitation) is essential to maintaining the range of motion obtained intra-operatively.

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