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EXTENSION DEFICIT AFTER ACL RECONSTRUCTION…
217
Table 3:
Literature review of the posterior open and arthroscopic debridement series.
Follow up
Treatment
ROM Results
Clinical results
complications
17 months
(4-38)
Medial parapatellar
anterior extensile
approach
Extension 8° (-15 to 5°) to 4°
(-15 to 5)
Flexion 69°(30-90) to
136°(125-145)
No
1 additional mob under
anesthesia at 10 days
57 months
(9-13)
Medial parapatellar
anterior extensile
approach
ROM gain: 62°
Flexion gain: 81° (40-130)
to 125° (110 -145)
Extension loss: 18.8° (15-20)
to 1.25° (0-5)
All improvement significant
p<0.01
Mean improvement
Lysholm: 35.5
points (p<0.05)
3 subsequent
procedures:
1 manipulation under
anesthesia,
1 arthroscopic
debridement and one
ACLR/PCLR for knee
instability at 9 months
after open
debridement.
18 months
(6-38)
Arthroscopic arthrolysis
+ posteromedial open
capsulotomy
Extension gain: 15°
Preop: extension deficit 17°
(10°-30°)
Follow up: ext deficit 2°
Lysholm: 62 preop
and 88 postop.
Tegner score: 2.2 to
4 after arthrolysis
1 haematoma in the
posterior wound
(aspiration)
No neurovascular
complication
4.6 years (1-10)
Combined open
approach: anteromedial
+ posteromedial
Extension gain: 17°
No patient with more than 5°
of flexion contracture
Lysholm: 84
Tegner activity
scale: 1.9 to 4
2 synovial fistulas
1 haematoma
38 months
(6-90)
Double posteromedial
and posterolateral
approaches
ROM: 96° ±14,3 to 143° ±7
Extension: -16.25° ± 5.7
to 0.4° ± 1.4
Flexion: 112.5° ± 13.6
to 135.4° ± 5.8
Postop. subjective
IKDC:86.4±9.7
Postop. Objective
IKDC: 5A, 7B.
No
2.9 months
(0-20)
Arthroscopic posterior
arthrolysis with single
posteromedial portal
Extension loss: 13.6° (0-40)
to 3° (0-10)
Flexion gain: 91.6 ° (35-125)
to 117.8 ° (95-140)
N/D
N/D
12 months
Arthroscopic posterior
arthrolysis with both
posteromedial and
posterolateral portals
Extension loss: 34° (12-44)
to 3° (0-5)
Flexion gain: 85° (65-110)
to 100° (85-110)
N/D
Synovial fistula at the
posteromedial portal.
No neurovascular
deficits
24.1 months
(12.760.5)
Arthroscopic posterior
arthrolysis with single
posteromedial portal
Extension loss: 14.7° (7-28)
to 0.7° (0-15)
Flexion gain: 116.3° (76-135)
to 130.1° (120-135)
N/D
No
MM:
medial menisectomy,
MCL:
medial collateral ligament,
LCL:
lateral collateral ligament,
ORIF:
open reduction
and internal fixation,
ACLR:
anterior cruciate ligament reconstruction,
PCLR:
posterior cruciate ligament reconstruction;
OCD:
osteochondritis dissecans;
N/D:
non documented. The solid line separates the open and arthroscopic series.