Exercise Program in Post-Surgical Release of Knee Flexion Contracture in Patient with Osteochondroma: A Case Report

Introduction: Knee flexion contracture is caused by adaptive shortening of the muscles which is marked by the incapability of the knee to fully extend. This condition is associated with long periods of immobilization, pain, and muscle weakness that are caused by various pathological conditions. Post-surgical rehabilitation program is mainly aimed to recover basic lower limb functions through an exercise program. Case description: A 16-year-old male patient with a history of left-sided knee pain and fixed flexion contracture was undergone a surgical release procedure and diagnosed with osteochondroma. Post-surgical evaluation by physical therapist found muscle atrophy, limited range of motion, and pain on the operated limb. The patient was instructed to do muscle strengthening and active exercise on both legs. Exercise program post-surgery aimed to improve muscle strength, range of motion, functional limb ability and activities of daily living. Improvement in the range of motion of the left knee joint was observed after three sessions of physical therapy intervention. Conclusion: Exercise program could reduce the muscle contracture and improve the knee joint range of motion in patients with osteochondroma following surgical release procedure.

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Intra-articular collagenase injection increases range of motion in a rat knee flexion contracture model

Drug Design Development and Therapy ◽

10.2147/dddt.s144602 ◽

2017 ◽

Vol Volume 12 ◽

pp. 15-24 ◽

Cited By ~ 4

Author(s):

Kayleigh Wong ◽

Guy Trudel ◽

Odette Laneuville

Keyword(s):

Range Of Motion ◽

Knee Flexion ◽

Flexion Contracture ◽

Knee Flexion Contracture ◽

Collagenase Injection

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Reliability of Heel-Height Measurement for Documenting Knee Extension Deficits

The American Journal of Sports Medicine ◽

10.1177/03635465020300040501 ◽

2002 ◽

Vol 30 (4) ◽

pp. 479-482 ◽

Cited By ~ 15

Author(s):

Theodore F. Schlegel ◽

Martin Boublik ◽

Richard J. Hawkins ◽

J. Richard Steadman

Keyword(s):

Range Of Motion ◽

Knee Flexion ◽

Cruciate Ligament ◽

Flexion Contracture ◽

Height Measurement ◽

Height Difference ◽

Thigh Circumference ◽

Flexion Contractures ◽

Heel Height ◽

Knee Flexion Contracture

Background Heel-height difference has been used to detect subtle knee flexion contractures, but the effects of thigh circumference differences and patient positioning during testing have not been evaluated. Hypothesis Differences in thigh circumference measurements and whether the patient's patellae are on or off the examination table during heel-height difference measurement will not affect the accuracy of detecting knee flexion contracture. Study Design Prospective cohort study. Methods Bilateral knee range of motion, prone heel-height difference with the patellae on and off the table, and thigh circumference at 5 and 15 cm proximal to the proximal pole of the patella were measured by one investigator on 50 consecutive patients who had undergone unilateral anterior cruciate ligament reconstruction. Results A high degree of correlation was demonstrated between the heel-height difference and the standard range of motion measurement. Differences in thigh girth and patellar position did not statistically affect the accuracy of the heel-height difference as an indicator of knee flexion contracture. Conclusion Heel-height difference is a valid method of documenting knee flexion contractures. Compared with traditional goniometer assessment, this test is a more meaningful and easier way for detecting subtle knee flexion contractures of less than 10°.

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Recurrence of knee flexion contracture after surgical correction in children with cerebral palsy

International Orthopaedics ◽

10.1007/s00264-021-05035-z ◽

2021 ◽

Author(s):

Supitchakarn Cheewasukanon ◽

Phatcharapa Osateerakun ◽

Noppachart Limpaphayom

Keyword(s):

Cerebral Palsy ◽

Knee Flexion ◽

Flexion Contracture ◽

Surgical Correction ◽

Knee Flexion Contracture ◽

Children With Cerebral Palsy

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The influence of preoperative knee flexion contracture severity on short-term outcome of orthopedic surgery in ambulatory children with bilateral cerebral palsy

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04362-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Evelina Pantzar-Castilla ◽

Brian Po-Jung Chen ◽

Freeman Miller ◽

Jacques Riad

Keyword(s):

Cerebral Palsy ◽

Motor Function ◽

Surgical Procedures ◽

Orthopedic Surgery ◽

Knee Flexion ◽

Flexion Contracture ◽

Short Term ◽

Knee Flexion Contracture ◽

Group 2 ◽

Group 1

Abstract Background Indications and cutoff value of deformities to determine surgical procedures for flexed knee gait are not clear. The aim was to determine the influence of none or mild, and moderate preoperative knee flexion contracture on the improvement of gait after orthopedic surgery in children with bilateral cerebral palsy (CP). Methods Inclusion criteria; bilateral CP, Gross Motor Function Classification System level I-III, and pre- and post operative-gait analysis. The 132 individuals identified were categorized into 2 groups based on the severity of knee flexion contracture (group 1: none or less than 11°; group 2: greater than or equal to 11°), and then matched according to the exact same soft tissue and/or bony orthopedic surgical procedures performed. The indication for surgery was to prevent progressive development of knee flexion contracture and stance phase flexed knee gait. Pre- and postoperative physical examination and gait analysis data were analyzed retrospectively. Results Sixty (30 + 30) children, with mean age 10.6 years in each group, were included. The average follow-up time was 17 months. Gait Deviation Index (GDI) improved in group 1 from mean 66 (SD 19) to 74 (15), p = 0.004, and in group 2 from 60 (13) to 69 (15), p = 0.001. Knee flexion in stance improved in group 1 from 21.4 (16.1) to 12.1 (16.0) degrees, p = 0.002, and in group 2 from 32.2 (14.2) to 17.0 (15.9), p = 0.001. Step length improved in both groups, p = 0.017 and p = 0.008, respectively. Only in group 2 significant improvement was noted in walking speed, p = 0.018 and standing function, Gross Motor Function Measure (GMFM-D), p = 0.001. Knee flexion contracture decreased in group 1 from mean 4.6 (5.3) to 2.1 (8.3) degrees, p = 0.071 and in group 2 from 17.2 (4.9) to 9.6 (9.3), p = 0.001. There was no statistical difference between groups in pre-post improvement of GDI or other variables, except GMFM-D. Conclusions Relative mild to moderate preoperative knee flexion contracture does not influence the short-term improvement of gait after orthopedic surgery in children with bilateral CP.

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Using a Knee Arthrometer to Evaluate Tissue-specific Contributions to Knee Flexion Contracture in the Rat

Journal of Visualized Experiments ◽

10.3791/58084 ◽

2018 ◽

Author(s):

T. Mark Campbell ◽

Katherine Reilly ◽

Louis Goudreau ◽

Odette Laneuville ◽

Hans Uhthoff ◽

...

Keyword(s):

Knee Flexion ◽

Flexion Contracture ◽

Tissue Specific ◽

Knee Flexion Contracture

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The effect of patient positioning on the accuracy and reliability of assessment of knee range of motion over a telemedicine platform

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211046787 ◽

2021 ◽

pp. 1357633X2110467

Author(s):

Sean Wei Loong Ho ◽

Kelvin Guoping Tan ◽

Eng Chuan Neoh ◽

Jiayen Wong ◽

Atiq Syazwani Roslan ◽

...

Keyword(s):

Knee Joint ◽

Range Of Motion ◽

Supine Position ◽

Knee Flexion ◽

Patient Positioning ◽

Flexion Angle ◽

Visual Estimation ◽

Limits Of Agreement ◽

Joint Range Of Motion ◽

Joint Range

Introduction Diagnostic accuracy is one of the key considerations of telemedicine usage in orthopedic surgery. The aim of this study was to determine the optimal patient positioning to achieve accurate and reliable visual estimation of the knee joint range of motion over a digital platform for telemedicine. Methods A single volunteer was recruited to perform a total of 120 discrete and random knee range of motion angles in three patient positions: sitting, standing and supine. The patient image was broadcast over a digital platform to six raters. The raters recorded their visual estimation of each discrete knee flexion angle independently. After each discrete knee flexion angle, a physical goniometer was used to obtain the actual flexion angle of the knee. Results A total of 120 discrete measurements (40 measurements in the sitting, standing, and supine positions each) were recorded by each of the six raters. The supine position resulted in the highest intraclass correlation of 0.97 (95% confidence interval: 0.98, 0.99). All three patient positions achieved low absolute difference between the goniometer and the raters with 5.6 degrees (95% limits of agreement: −21.0, 9.8) in sitting, 2.7 degrees (95% limits of agreement: −10.1, 15.4), and 1.2 degrees (95% limits of agreement: −9.8, 12.3) in the supine position. The supine position had the highest accuracy and reliability. Discussion Visual estimation of the knee joint range of motion over telemedicine is clinically accurate and reliable. Patients should be assessed in a supine position to obtain the highest accuracy and reliability for visual estimation of the knee joint range of motion during telemedicine.

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