Clinical Results After Judet Quadricepsplasty for Post-traumatic Knee Stiffness

NCT06251765 — Completed, 20 participants, Istituto Ortopedico Rizzoli

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Clinical Results After Judet Quadricepsplasty for Post-traumatic Knee Stiffness: a Retrospective and Prospective Observational Study

RegistryNCT06251765
StatusCompleted
Study typeObservational
Enrollment20 (Actual)
SponsorIstituto Ortopedico Rizzoli (Other)
ConditionsKnee Fractures, Stiffness of Knee, Not Elsewhere Classified
InterventionsClinical scores, Range of Motion (Other)
Datesstart 2024-07-10, primary completion 2024-10-18, completion 2024-10-18, first posted 2024-02-09, last updated 2024-10-21
Locations1 site in Italy

Related Papers Related Patents Related Grants Related Experts
All trials for Knee Fractures All trials for Stiffness of Knee, Not Elsewhere Classified All trials of Clinical scores All trials of Range of Motion

-Summary

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.

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+Arms and interventions

ArmTypeInterventionsDescription
PatientsOther: Clinical scores; Other: Range of MotionPatients who underwent Judet arthromyilisis for treatment of post-traumatic knee stiffness
  • Clinical scores (Other): Clinical scores will be administered to patients
  • Range of Motion (Other): Evalutation of knee mobility

+Outcome measures

Primary outcomes

  • Range of Motion at follow-up [baseline time 0]: ROM expresses in degrees the degree of range of motion that a joint can perform along its full range of motion whether active or passive through an external aid.

Secondary outcomes

  • Intra-operative Range of Motion [baseline time 0]: ROM expresses in degrees the degree of range of motion that a joint can perform along its full range of motion whether active or passive through an external aid.
  • Knee injury and Osteoarthritis Outcome Score [baseline time 0]: KOOS assesses patient pain (9 items), other symptoms (7 items), function in daily living (17 items), function in sport and recreation (5 items), and knee related quality of life (4 items). Scores range from 0 to 100 with a score of 0 indicating the worst possible knee symptoms and 100 indicating no knee symptoms. The KOOS is a patient reported joint-specific score, which may be useful for assessing changes in knee pathology over time, with or without treatment.
  • Tegner Activity Scale [baseline time 0]: Tegner Activity Scale is used in order to provide a standardized method to grade work and sporting activities.

+Eligibility

Sex: All, ages: 18 Years to any

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.

+Locations (1)

FacilityCityCountryStatus
IRCCS Istituto Ortopedico RizzoliBolognaItaly

+Publications

  • Results publication: Pujol N, Boisrenoult P, Beaufils P. Post-traumatic knee stiffness: surgical techniques. Orthop Traumatol Surg Res. 2015 Feb;101(1 Suppl):S179-86. doi: 10.1016/j.otsr.2014.06.026. Epub 2015 Jan 9. PMID 25583236
  • Results publication: Luo Y, Li H, Mei L, Mao X. Effects of Judet Quadricepsplasty in the Treatment of Post-traumatic Extension Contracture of the Knee. Orthop Surg. 2021 Jun;13(4):1284-1289. doi: 10.1111/os.12950. Epub 2021 May 6. PMID 33955701
  • Results publication: Bidolegui F, Pereira SP, Pires RE. Safety and efficacy of the modified Judet quadricepsplasty in patients with post-traumatic knee stiffness. Eur J Orthop Surg Traumatol. 2021 Apr;31(3):549-555. doi: 10.1007/s00590-020-02802-3. Epub 2020 Oct 13. PMID 33051692