Knee extension contracture with fixed anterior tibia subluxation treated with PCL release and quadricepsplasty: a case report

Abstract

Abstract 58‐year‐old male presented with knee extension contracture (25°) with iatrogenic fixed anterior tibial subluxation. Consecutive arthroscopic arthrolysis, manipulation under anesthesia, and quadriceps‐Z‐plasty during one surgery failed to restore flexion. Therefore, shortened posterior cruciate ligament was released, which eliminated subluxation and allowed 115° flexion. Despite physiotherapy, flexion progressively decreased to 70° postoperatively. Revision quadricepsplasty by transverse incisions restored 120° of flexion maintained at 31‐months follow‐up. International Knee Documentation Committee increased 4/87‐ > 50/87, Knee injury and Osteoarthritis Outcome 7/100‐ > 68/100 at follow‐up. Posterior cruciate ligament release and repeated quadricepsplasty could be a viable salvage option in severe extension contracture with fixed anterior tibial subluxation.

Keywords

• Posterior cruciate ligament
• Release
• Severe
• Extension contracture
• Flexion deficit, fixed anterior tibial subluxation
• Quadricepsplasty