Flexion contracture after total knee arthroplasty in a patient with Parkinson's disease: successful treatment with botulinum toxin type A.
The few reports in the orthopedic literature that discuss outcomes after total knee arthroplasty in patients with Parkinson's disease cite mixed results. These patients are at increased risk for the development of flexion contracture, which has been shown to significantly worsen functional scores. The present report describes the development of a flexion contracture in a patient with Parkinson's disease after total knee arthroplasty. This contracture was successfully treated with manipulation under anesthesia and injections of botulinum toxin type A into the hamstring and gastrocnemius muscles, in conjunction with a static progressive extension orthosis and rigorous physical therapy.
Shah
Steven N
SN
Department of Orthopaedic Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA.
Hornyak
Joseph
J
Urquhart
Andrew G
AG
D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003286:Contracture / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular
D019274:Botulinum Toxins, Type A