title: Percutaneous quadriceps tendon pie-crusting release of extension contracture of the knee.
abstract: To release extension contracture of the knee, the authors used a minimally invasive technique: percutaneous quadriceps tendon pie-crusting release. Percutaneous pie-crusting release was performed using an 18-gauge needle to puncture the stiff fibrous band of the distal and lateral quadriceps tendon under maximum knee flexion. Quadriceps contracture was gradually released by multiple needle punctures. A knee brace was prescribed for one week and knee flexion exercises were performed on the first postoperative day. This technique was performed in seven post-traumatic stiff knees and five stiff total knee arthroplasties. Mean maximum flexion increased from 37° preoperatively to 50° after arthrolysis and 107(o) after pie-crusting. At a mean follow-up of eight months, mean maximum flexion was 103°. There were no major complications. The technique of quadriceps tendon pie-crusting release is a simple, minimally invasive and effective treatment for knee extension contracture.
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109, Xueyuanxi road, 32027 Wenzhou, China.
authors.forename: H X
authors.initials: HX
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109, Xueyuanxi road, 32027 Wenzhou, China. Electronic address: wenhongd08@163.com.
authors.forename: H
authors.initials: H
authors.lastname: Wen
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109, Xueyuanxi road, 32027 Wenzhou, China.
authors.forename: Y Z
authors.initials: YZ
authors.lastname: Hu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109, Xueyuanxi road, 32027 Wenzhou, China.
authors.forename: H C
authors.initials: HC
authors.lastname: Yu
authors.affiliation: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109, Xueyuanxi road, 32027 Wenzhou, China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Pan
mesh_terms: D003286:Contracture / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D052097:Quadriceps Muscle / Q000601:surgery*; D016059:Range of Motion, Articular; D013710:Tendons / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Flexion contracture; Pie-crusting; Quadriceps; Stiff knee