MYOTENOGENIC QUADRICEPSPLASTY IN ARTHROGRYPOSIS OF THE KNEE JOINT
DOI:
https://doi.org/10.11603/2414-4533.2025.1.15175Keywords:
arthrogryposis, fibrosis, tenoplasty, autoallograft, knee jointAbstract
The aim of the work: to demonstrate a successful case of treatment of total fibrosis of quadriceps tendon with a combined auto-allograft in arthrogryposis of the knee joint.
Materials and Methods. Among congenital malformations of the musculoskeletal system, arthrogryposis is one of the most severe diseases with many lesions, the development of pain syndrome against the background of multiple congenital contractures, pronounced deformation, muscle hypotonia, hyporeflexia, vegetative-visceral disorders, etc. This disease can be detected during prenatal diagnosis in the 2nd–3rd trimesters of pregnancy using ultrasound in combination with counting fetal movements. Sonographically, total fibrosis and absence of the quadriceps tendon were examined (total defect of about 15 cm). And then the tendon part of the quadriceps muscle was plasticized using a cadaveric allograft of the Achilles tendon and part of the patient’s own iliotibial tract.
Results. A clinical case of a 21-year-old patient with arthrogryposis is presented, who was repeatedly operated on in leading clinics for lower limb deformity and contractures. However, about a year ago, the patient noted a gradual loss of active extensor function in the knee joint. Total fibrosis and absence of the quadriceps tendon were detected. Myotenogenic plasty of the quadriceps was performed. The postoperative period was without complications, the patient was discharged for outpatient treatment on the 3rd day after surgery in a satisfactory condition and with relieved pain syndrome in the acute period. The wound healed with primary tension, the sutures were removed on the 14th day after surgery. Immobilization with a splint was 4 weeks. Active extensor movements in the lower leg and hip flexion were restored, she walks without assistance.
Conclusions. The technique of autoalloplasty of tendon defects in arthrogryposis is effective provided that the patient follows the recommendations in the postoperative period, as well as long-term rehabilitation treatment.
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