Extension Contracture Post Total Knee Replacement: A Case Report

Abstract

BACKGROUND: Stiffness is a common problem after knee arthroplasty and need for further procedure. Patients who experience this problem usually have poor outcome. Flexion contracture is the most reported case in most case reports; however, we reported a rare case of patient with extension contracture after total knee arthroplasty (TKA).
 CASE REPORT: A 62-year-old woman was presented with a 3-month history of right TKA. After 3 month she came to the hospital and complained that she could not flex the knee. Nevertheless, she could still walk. On the right knee, there was quadriceps hypotrophy. There was no active and passive range of motion (ROM), because it was fixed at 0°. We performed medial parapatellar approach for knee arthrotomy and we added lateral parapatellar arthrotomy to release the contracture. The fibrotic tissues were removed. The flexion and extension of the knee were evaluated and we managed to get 0–130° of flexion-extension ROM. In the ward, the patient was treated using continuous passive motion (CPM) for 1 week and the CPM was maintained within the range of 0–130°. Six months after surgery, the patient could walk normal with ROM range between 0 and 100°.
 CONCLUSION: Stiff knee is a common problem after TKA. Close observation and proper rehabilitation can prevent stiff knee. Close manipulation, manipulation under anesthesia, arthroscopy debridement, and open contracture release are the option of this problem.