ABSTRACT
Various techniques have been described for the treatment of soft tissue extension
contracture of the knee. Some involve large exposures, and others can result in a
permanent extensor lag. We describe a technique with limited exposure, avoiding transverse
incisions in the rectus femoris. Through a midline incision, the extensor expansion
is exposed. The rectus femoris is separated from the vastus medialis, lateralis, and
intermedius to form a strap-like structure. Vastus intermedius is separated from the
patella. If firm, careful manipulation of the knee is unsuccessful, the incisions
are extended distally along both sides of the patella and patellar tendon, releasing
the extensor mechanism from any underlying heterotopic bone, and further manipulation
of the knee is performed. Postoperatively, a rehabilitation program is begun. A good
outcome following this technique is described in 3 knees presenting with severe restriction
of knee flexion. There were no wound complications and no residual extensor lag.
