Case report

The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature

¹ Department of Orthopaedic Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng 308433  
² Department of Orthopaedic Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828

^* Corresponding author. MBBS, MRCS 11 Jalan Tan Tock Seng Singapore 308433. E-mail address: ding.tze.keong.benjamin@gmail.com (B. T. K. Ding).

Received: 25 March 2019
Accepted: 23 April 2019

Abstract

Traumatic injuries to the knee are frequently complicated by extension contractures. The Judet Quadricepsplasty allows for controlled, sequential release of extrinsic and intrinsic knee contracture components while reducing the potential for iatrogenic quadriceps rupture. We document our institutions experience with this procedure and a systematic review of the current literature. We followed up on an elderly patient with posttraumatic flexion contracture that failed conservative management and underwent Judet Quadricepsplasty. Her knee range of motion improve dramatically from 20 degrees of flexion to 100 degrees of flexion. There was a residual extension lag of 5 degrees which did not impede on the patients daily activities. A review of the literature was performed and relevant data from 12 articles was extracted. The procedure was mainly performed in young adult males in most previous studies and the range of motion improvement ranged from 51° to 110°. Wound infections were the most common complication but otherwise other complications and severe extension lag were rare. The Judet Quadricepsplasty is a useful procedure for severe extension knee contractures that has failed conservative management in all age groups of patients. It is associated with significant increases in range of motion with low rates of complication or extension lag.

Diagnostic IV