Clinical Results After Judet Quadricepsplasty for Post-traumatic Knee Stiffness

NCT06251765 | Completed

• 1 other identifier: JUD-TR
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

Knee Fractures; Stiffness of Knee, Not Elsewhere Classified

Keywords

arthromyolisis; Judet; post-traumatic; quadricepsplasty

Outcome Measures

Primary Outcomes (1)

• Range of Motion at follow-up

  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.

  baseline time 0

Secondary Outcomes (3)

• Intra-operative Range of Motion

  baseline time 0

• Knee injury and Osteoarthritis Outcome Score

  baseline time 0

• Tegner Activity Scale

  baseline time 0

Study Arms (1)

Patients

Patients who underwent Judet arthromyilisis for treatment of post-traumatic knee stiffness

Other: Clinical scores; Other: Range of Motion

Interventions

Clinical scores OTHER

Clinical scores will be administered to patients

Patients

Range of Motion OTHER

Evalutation of knee mobility

Patients

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients who underwent Judet arthromyolisis for treatment of post-traumatic knee-stiffness

You may qualify if:

• Adult patients underwent surgical intervention for arthromyolysis according to Judet with modified surgical technique for knee stiffness from January 2008 to December 2019.
• Patients with post-traumatic injuries (fractures treated surgically).
• Patients with a minimum of 4 years of follow-up.
• Completeness of clinical documentation.

You may not qualify if:

• Patients who underwent surgical intervention for arthrolysis (both arthroscopic and non-arthroscopic) or arthromyolysis according to Judet with minimally invasive technique.
• Patients who underwent surgery to address knee stiffness due to other causes (rigid prosthesis, limb lengthening, etc.).
• Incomplete clinical documentation.

Sponsors & Collaborators

• Istituto Ortopedico Rizzoli: lead

Study Sites (1)

IRCCS Istituto Ortopedico Rizzoli

Bologna, 40136, Italy

Location

Related Publications (3)

• 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 RESULT

• 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 RESULT

• 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 RESULT

MeSH Terms

Conditions

Knee Fractures

Interventions

Range of Motion, Articular

Condition Hierarchy (Ancestors)

Fractures, Bone; Wounds and Injuries; Knee Injuries; Leg Injuries

Intervention Hierarchy (Ancestors)

Physical Examination; Diagnostic Techniques and Procedures; Diagnosis; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: February 1, 2024
• First Posted: February 9, 2024
• Study Start: July 10, 2024
• Primary Completion: October 18, 2024
• Study Completion: October 18, 2024
• Last Updated: October 21, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)