Usage of External Fixation in the Treatment of Adult Patients with Knee Joint Stiffness: Review

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Abstract

Relevance. Knee contractures have an impact on quality of life and are also a common cause of disability. The use of external fixation devices has a certain place in the treatment of this pathology.

Purpose. Using the world literature, to identify the modern position, problems, and prospectives of external fixation in the treatment of knee flexion and extension contractures in adult patients.

Methods. EMBASE, Medline, Google Scholar, PubMed, e-LIBRARY, and Cyber resources were used. The analysis included publications relative treatment of knee joint stiffness using external fixation in patients over 18 years old, regardless of gender. At analysis several criterial were used: frame ability to provide movements in the knee joint according with its natural kinematics (biomechanics), stable fixation of the femur and tibia, and possibility inserting wires and halfpins in projection of Reference Positions (RP).

Results. The devices used in the treatment of knee joint contractures in adult patients were conditionally divided, depending on the type of hinge, into 4 groups: non-hinged, uniaxial, reproducing, and virtual. It has been established that only orthopedic hexapods, based on virtual hinge, can meet all of the criteria mentioned above. However the technology of any orthopedic hexapod hardware and software usage for the treatment of contractures of the knee joint, was not developed till now.

Conclusion. The necessity of developing hex-based technology for treatment patients with knee joint contractures was justified by world literature review. Hexapod hardware must provide possibilities of any inclination angle of any ring, and struts fixation not only to base and mobile rings, but to stabilizing as well. Software should be equipped with multi-total residual option. Ortho-SUV Frame (OSF) meets these requirements.

About the authors

S. A. Rokhoev

National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: 09saga@mail.ru
ORCID iD: 0000-0003-4369-9619

Saigidula A. Rokhoev — PhD Student

St. Petersburg

Россия

L. N. Solomin

National Medical Research Center of Traumatology and Orthopedics; St. Petersburg State University; LLC “Ortho-SUV”

Email: solomin.leonid@gmail.com
ORCID iD: 0000-0003-3705-3280

Leonid N. Solomin — Dr. Sci. (Med.), Professor, Leading Researcher of the department of treatment of Injuries and their consequences; Professor of the Surgery Chair Medical Faculty; director

St. Petersburg

Россия

References

  1. Fick R. Handbuch der Anatomie und Mechanik der Gelenke: T. Spezielle Gelenk-und Muskelmechanik. Jena: G. Fischer; 1911. Vol. 3. p. 531-593.
  2. Евсеев В.И. Биомеханика повреждений коленного сустава. Москва: РУСАЙНС; 2018. с. 45-69.
  3. Evseev V.I. [Biomechanics of knee injuries]. Moscow: RUSAJNS; 2018. p. 45-69. (In Russian).
  4. Muller W. Kinematics. In The Knee: Form, Function, and Ligament Reconstruction. New York: Springer-Verlag; 1983. р. 8-75.
  5. Schwartz C.l. Conservation du ligament croisé antérieur. Orthop Traumatol. 1993;(3):105-107.
  6. Freeman M.A.R., Pinskerova V. The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res. 2003;(410):35-43. doi: 10.1097/01.blo.0000063598.67412.0d.
  7. Pinskerova V., Iwaki H., Freeman M.A. The shapes and relative movements of the femur and tibia at the knee. Orthopade. 2000;29 Suppl 1:S3-5. doi: 10.1007/pl00003679.
  8. McPherson A., Kärrholm J., Pinskerova V., Sosna A., Martelli S. Imaging knee position using MRI, RSA/CT and 3D digitisation. J Biomech. 2005;38(2):263-268. doi: 10.1016/j.jbiomech.2004.02.007.
  9. Iwaki H., Pinskerova V., Freeman M.A. Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br. 2000;82(8):1189-1195. doi: 10.1302/0301-620x.82b8.10717.
  10. Барков А.В., Барков А.А. Лечение разгибательных контрактур коленных суставов у пациентов с переломами бедренной кости осложненных несращением, остеомиелитом и дефектами кости. Літопис травматології та ортопедії. 2009;(1-2):182-184.
  11. Barkov A.V., Barkov A.A. [Treatment of extensional contracture the knee joint in patients with fractures complicated with non-union, osteomyelitis and bone defects. Lіtopis travmatologії ta ortopedії [Litopys of Traumatology and Orthopedics]. 2009;(1-2):182-184. (In Russian).
  12. Leardini A., Belvedere C., Nardini F., Sancisi N., Conconi M., Parenti-Castelli V. Kinematic models of lower limb joints for musculo-skeletal modelling and optimization in gait analysis. J Biomech. 2017;62:77-86. doi: 10.1016/j.jbiomech.2017.04.029.
  13. Mousavi H., Mir B., Safaei A. Evaluation of Thompson’s quadricepsplasty results in patients with knee stiffness resulted from femoral fracture. J Res Med Sci. 2017;22:50. doi: 10.4103/1735-1995.205237.
  14. Salzman B. Gait and balance disorders in older adults. Am Fam Physician. 2010;82(1):61-68.
  15. Simonsen E.B. Contributions to the understanding of gait control. Dan Med J. 2014;61(4):B4823.
  16. Ding B.T.K., Khan S.A. The judet quadricepsplasty for elderly traumatic knee extension contracture: a case report and review of the literature. Biomedicine (Taipei). 2019;9(3):21. doi: 10.1051/bmdcn/2019090321.
  17. Protopapadaki A., Drechsler W.I., Cramp M.C., Coutts F.J., Scott O.M. Hip, knee, ankle kinematics and kinetics during stair ascent and descent in healthy young individuals. Clin Biomech. 2007;22(2):203-210.
  18. Norkin C.C, White D.J. Measurement of Joint Motion: A Guide to Goniometry. Philadelphia: PA, FA Davis Co; 1985. 572 p.
  19. Gomes J.L.E., Ruthner R.P., Moreira L. Femoral pseudoarthrosis and knee stiffness: long-term results of a one-stage surgical approach. Arch Orthop Trauma Surg. 2010;130(2):277-283. doi: 10.1007/s00402-009-0938-1.
  20. Razaq M.N., Muhammad T., Ahmed A., Adeel M., Ahmad S., Ahmad S., Sultan S. Outcomes of distal femur fracture treated with dynamic condylar screw. JAMC. 2016;28(2):259-261.
  21. Назаров Х.Н., Линник С.А., Мирзоев Р.Р. Профилактика и лечение посттравматической контрактуры, анкилозов и артрозов суставов при сочетанных и множественных травмах нижних конечностей. Вестник Академии медицинских наук Таджикистана. 2018;(3):341-348.
  22. Nazarov Kh.N., Linnik S.A., Mirzoev R.R. [Prevention and treatment of post-relative contract, ankilozos and arthrosov joints in combined and multiple lips of lower limbs]. Vestnik Akademii meditsinskikh nauk Tadzhikistana [Bulletin of Medical Science Academy of Tajikistan]. 2018;(3):341-348. (In Russian).
  23. Kumari A., Yadav S. Cerebral Palsy: a mini review. Int J Ther App. 2012;3(1):15-24.
  24. Данилов А.А., Балицкая Ю.Л., Моця М.А. Лечение сгибательных контрактур коленных суставов у детей с церебральным параличом. Хирургия детского возраста. 2014;(3-4):35-41.
  25. Danilov A.A., Balickaya Y.L., Motcia M.A. [Treatment of flexion contractures of knee joints in children with cerebral palsy]. Khirurgiya detskogo vozrasta [Pediatric surgery. Ukraine]. 2014;(3-4):35-41. (In Russian).
  26. Хатькова С.Е., Акулов М.А., Орлова О.Р., Усачев Д.Ю., Орлова А.С., Крылова Л.В. Ботулинотерапия в лечении спастичности нижней конечности. Нервно- мышечные болезни. 2017;7(3):21-35.
  27. Khat’kova S.E., Akulov M.A., Orlova O.R., Usachev D.Yu., Orlova A.S., Krylova L.V. [Botulinum toxin treatment of lower extremity spasticity]. Nervno-myshechnye bolezni [Neuromuscular diseases]. 2017;7(3):21-35. (In Russian).
  28. Клочкова О.А., Куренков А.Л., Кенис, В.М. Формирование контрактур при спастических формах детского церебрального паралича: вопросы патогенеза. Ортопедия, травматология и восстановительная хирургия детского возраста. 2018;6(1):59-66. doi: 10.17816/PTORS6158-66.
  29. Klochkova O.A., Kurenkov A.L., Kenis V.M. [Development of contractures in spastic forms of cerebral palsy: pathogenesis and prevention]. Ortopediya, travmatologiya i vosstanovitel’naya khirurgiya detskogo vozrasta [Pediatric traumatology, orthopaedics and reconstructive surgery]. 2018;6(1):59-66. (In Russian). doi: 10.17816/PTORS6158-66
  30. Kundu Z., Sangwan S., Guliani G., Siwach R., Kamboj P., Singh R. Thompson’s quadricepsplasty for stiff knee. Indian J Orthop. 2007;41(4):390-394. doi: 10.4103/0019-5413.37004.
  31. Hahn S.B., Choi Y.R., Kang H.J., Lee S.H. Prognostic factors and long-term outcomes following a modified Thompson’s quadricepsplasty for severely stiff knees. J Bone Joint Surg Br. 2010;92(2):217-221. doi: 10.1302/0301-620X.92B2.22936.
  32. Schnitzler A., Genêt F., Diebold A., Mailhan L., Jourdan C., Denormandie P. Lengthening of knee flexor muscles by percutaneous needle tenotomy: Description of the technique and preliminary results. PLoS One. 2017;12(11):e0182062. doi: 10.1371/journal.pone.0182062.
  33. Marfo K.A., Berend K.R., Lombardi Jr. A.V. Flexion contractures: A stepwise algorithmic approach. Semin Arthroplasty. 2018;29(3):229-235. doi: 10.1053/j.sart.2019.01.009.
  34. Novacheck T.F., Stout J.L., Gage J.R., Schwartz M.H. Distal femoral extension osteotomy and patellar tendon advancement to treat persistent crouch gait in cerebral palsy: surgical technique. J Bone Joint Surg Am. 2009:91(2):271-286. doi: 10.2106/JBJS.I.00316.
  35. Park H., Park B.K., Park K.B., Abdel-Baki S.W., Rhee I. et al. Distal Femoral Shortening Osteotomy for Severe Knee Flexion Contracture and Crouch Gait in Cerebral Palsy. J Clin Med. 2019;8(9):1354. doi: 10.3390/jcm8091354.
  36. Gaurav K., Vilas J. A new approach to the management of fixed flexion deformity of the knee using Ilizarov’s principle of distraction histogenesis: a preliminary communication. Int J Low Extrem Wounds. 2010;9(2):70-73. doi: 10.1177/1534734610371559.
  37. Lee D.H., Kim T.H., Jung S.J., Cha E.J., Bin S.I. Modified judet quadricepsplasty and Ilizarov frame application for stiff knee after femur fractures. J Orthop Trauma. 2010;24(11):709-715. doi: 10.1097/BOT.0b013e3181c80bb9.
  38. Vulcano E., Markowitz J.S., Fragomen A.T., Rozbruch S.R. Gradual correction of knee flexion contracture using external fixation. J Limb Lengthen Reconstr. 2016;2(2):102-107. doi: 10.4103/2455-3719.190712.
  39. Оганесян О.В. Основы наружной чрескостной фиксации. Москва: Медицина; 2004. с. 66-118. Oganesyan O.V. [The basics of external transosseous fixation]. Moscow: Meditsina; 2004. p. 66-118. (In Russian).
  40. Соломин Л.Н. Основы чрескостного остеосинтеза. М.: БИНОМ; 2014. Т. 1. Гл. 9. c. 116-133.
  41. Solomin L.N. [Basics transosseous osteosynthesis]. М.: Binom; 2014. Vol. 1, Ch. 9. p. 116-133. (In Russian).
  42. Ruthig H. Zur Behandlung der Kniebeugekontrakturen [Treatment of popliteal space contractions]. Dtsch Gesundheitsw. 1953;8(35):1050-1053.
  43. Оганесян О.В. Лечение заболеваний суставов с помощью шарнирно-дистракционных аппаратов. Москва: Медицина; 1975. с. 29-32.
  44. Oganesyan O.V. Lechenie zabolevanij sustavov s pomoshh›ju sharnirno-distrakcionnyh apparatov [Treatment of joint diseases using hinge-distraction devices]. Moscow: Medicina; 1975. p. 29-32. (In Russian).
  45. Herzenberg J.E., Davis J.R., Paley D., Bhave A. Mechanical distraction for treatment of severe knee flexion contractures. Clin Orthop Relat Res. 1994;(301):80-88.
  46. Mugalur A., Pathak A.C., Shahane S.M., Samant A. Successful Correction of Idiopathic Bilateral Flexion Deformity of Knee: A Rare Case Report. J Orthop Case Rep. 2015;5(1):48-51. doi: 10.13107/jocr.2250-0685.254.
  47. Churchill D.L., Incavo S.J., Johnson C.C., Beynnon B.D. The transepicondylar axis approximates the optimal flexion axis of the knee. Clin Orthop Relat Res. 1998;(356):111-118. doi: 10.1097/00003086-199811000-00016.
  48. Elias S.G., Freeman M.A., Gokcay E.I. A correlative study of the geometry and anatomy of the distal femur. Clin Orthop Relat Res. 1990;(260):98-103.
  49. Hollister A.M., Kester M.A., Cook S.D., Bruset M.F., Haddad R.J. Knee axes of rotation: determination and implications. Trans Orthop Res Soc. 1986;(11):383.
  50. Hollister A.M., Jatana S., Singh A.K., Sullivan W.W., Lupichuk A.G. The axes of rotation of the knee. Clin Orthop Relat Res. 1993;(290):259-268.
  51. Catagni M.A., Malzev V., Kirienko A. Advances in Ilizarov Apparatus Assembly. Milan: Medicalplastic; 1996. p. 17-19.
  52. Standard S.C., Herzenberg J.E., Conway J.D., Lamm B.M., Siddiqui N.A. The art of limb alignment. Baltimore: Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore; 2019. p. 10-12.
  53. Damsin J.P., Ghanem I. Treatment of severe flexion deformity of the knee in children and adolescents using the Ilizarov technique. J Bone Joint Surg Br. 1996;78(1):140-144.
  54. Huang S.C. Soft tissue contractures of the knee or ankle treated by the llizarov technique: High recurrence rate in 26 patients followed for 3-6 years. Acta Orthop Scand. 1996;67(5):443-449. doi: 10.3109/17453679608996665.
  55. Balci H.I., Kocaoglu M., Eralp L., Bilen F.E. Knee flexion contracture in haemophilia: treatment with circular external fixator. Haemophilia. 2014;20(6):879-83. doi: 10.1111/hae.12478.
  56. Max Lingamfelter B.S., Sanchez H.B., Wagner R.A. Chronic Knee Dislocation and Flexion Contracture Treated with Open Reduction and External Fixation - A Case Report. J Arthritis. 2014;3(133). doi: 10.4172/2167-7921.1000133.
  57. Zhai J., Weng X., Zhang B., Peng H., Bian Y. Management of knee flexion contracture in haemophilia with the Ilizarov technique. Knee. 2019;26(1):201-206. doi: 10.1016/j.knee.2018.08.006.
  58. Оганесян О.В. Модернизированный аппарат для восстановления формы и функции коленного сустава. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2006;(4):29-34.
  59. Oganesyan O.V. [Modernized device for restoratıon of knee joint shape and function]. Vestnik travmatologii i ortopedii im. N.N. Priorova [N.N. Priorov Journal of Traumatology and Orthopedics]. 2006;(4):29-34. (In Russian).
  60. Попков А.В., Югай А.Е., Дьячкова Г.В. Лечение разгибательных контрактур коленного сустава методом Илизарова. Курган: ВКНЦ ВТО; 1991. с. 8-17.
  61. Popkov A.V., Yugay A.E., Dyachkova G.V. [Treatment of extension contractures of the knee joint by the Ilizarov method]. Kurgan: VKNC VTO; 1991. p. 10-17. (In Russian).
  62. Макушин В.Д., Бурлаков Э.В., Югай А. E.-Х. К обосно- ванию применения шарнирных устройств для устранения контрактур коленного сустава. Гений ортопе- дии. 1996;(4);52-55.
  63. Makushin V.D., Burlakov E.V., Yugay A.E.-Kh. To the rationale for the use of hinge devices for the elimination of contractures of the knee joint. Genij Ortopedii. 1996;(4);52-55. (In Russian).
  64. Волков М.В., Оганесян О.В. Восстановление формы и функции суставов и костей (аппаратами авторов). Москва: Медицина; 1986. 256 с.
  65. Volkov M.V., Oganesyan O.V. [Reduction of the shape and function of joints and bones (by the authors’ apparatus)]. Moscow.: Meditsina; 1986. p. 41-63. (In Russian).
  66. Taylor J. A new look at deformity correction. Distraction. The Newsletter of ASAMI - North America. 1997;5(1);204-209.
  67. Seide K., Wolter D., Kortmann H.R. Fracture reduction and deformity correction with the hexapod Ilizarov fixator. Clin Orthop Relat Res. 1999;(363):186-195.
  68. Соломин Л.Н., Корчагин К.Л., Утехин, А.И. Разработка оптимальной компоновки аппарата Орто-СУВ для разработки движений в коленном суставе. Травматология и ортопедия России. 2009;(4):21-26.
  69. Solomin L.N., Korchagin K.L., Utekhin A.I. [Development of optimal composition apparatus Ortho-SUV for the development movement in the knee joint]. Travmatologiya i ortopediya Rossii [Traumatology and Orthopedics of Russia]. 2009;(4):21-26. (In Russian).
  70. Соломин Л.Н., Утехин А.И., Виленский В.А. Орто-СУВ аппарат: чрескостный аппарат, работа которого основана на компьютерной навигации. Гений ортопедии. 2011;(2):148-156.
  71. Solomin L.N., Vilenskiy V.A., Utekhin A.I. [Ortho- SUV frame: external fixator working on the basis of computer navigation]. Genij Ortopedii. 2011;(2):161-169. (In Russian).
  72. Bawa H.S., Wera G.D., Kraay M.J., Marcus R.E., Goldberg V.M. Predictors of range of motion in patients undergoing manipulation after TKA. Clin Orthop Relat Res. 2013;471(1):258-263. doi: 10.1007/s11999-012-2591-1.
  73. Goldberg S.R., Ounpuu S., Arnold A.S., Gage J.R., Delp S.L. Kinematic and kinetic factors that correlate with improved knee flexion following treatment for stiff-knee gait. J Biomech. 2006;39(4):689-698. doi: 10.1016/j.jbiomech.2005.01.015.
  74. Beals R.K. Treatment of knee contracture in cerebral palsy by hamstring lengthening, posterior capsulotomy, and quadriceps mechanism shortening. Dev Med Child Neurol. 2001;43(12):802-805. doi: 10.1017/s0012162201001451.
  75. Khakharia S., Fragomen A.T., Rozbruch S.R. Limited quadricepsplasty for contracture during femoral lengthening. Clin Orthop Relat Res. 2009;467(11):2911-2917. doi: 10.1007/s11999-009-0951-2.
  76. Persico F., Vargas O., Fletscher G., Zuluaga M. Treatment of extraarticular knee extension contracture secondary to prolonged external fixation by a modified Judet quadricepsplasty technique. Strategies Trauma Limb Reconstr. 2018;13(1):19-24. doi: 10.1007/s11751-017-0302-x.
  77. Heydarian K., Akbarnia B.A., Jabalameli M., Tabador K. Posterior capsulotomy for the treatment of severe flexion contractures of the knee. J Pediatr Orthop. 1984;4(6):
  78. -704. doi: 10.1097/01241398-198411000-00009.
  79. Wallny T., Eickhoff H.H., Raderschadt G., Brackmann H.H. Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs. Haemophilia. 1999;5 Suppl 1:25-27. doi: 10.1046/j.1365-2516.1999.0050s1025.x.
  80. DelBello D.A., Watts H.G. Distal femoral extension osteotomy for knee flexion contracture in patients with arthrogryposis. J Pediatr Orthop. 1996;16(1):122-126. doi: 10.1097/00004694-199601000-00025.
  81. Hosny G.A., Fadel M. Managing flexion knee deformity using a circular frame. Clin Orthop Relat Res. 2008;466(12):2995-3002. doi: 10.1007/s11999-008-0530-y.
  82. Leong J.C., Alade C.O., Fang D. Supracondylar femoral osteotomy for knee flexion contracture resulting from poliomyelitis. J Bone Joint Surg Br. 1982;64(2):198-201. doi: 10.1302/0301-620X.64B2.7068740.
  83. Brunner R., Hefti F., Tgetgel J.D. Arthrogrypotic joint contracture at the knee and the foot: correction with a circular frame. J Pediatr Orthop B. 1997;6(3):192-197. doi: 10.1097/01202412-199707000-00007.
  84. Frankel V.H., Burstein A.H., Brooks D.B. Biomechanics of internal derangement of the knee. Pathomechanics as determined by analysis of the instant centers of motion. J Bone Joint Surg Am. 1971;53(5):945-962.
  85. Soudan K., Van Audekercke R., Martens M. Methods, difficulties and inaccuracies in the study of human joint kinematics and pathokinematics by the instant axis concept. Example: the knee joint. J Biomech. 1979;12(1):27-33. doi: 10.1016/0021-9290(79)90006-x.
  86. Sommers M.B., Fitzpatrick D.C., Kahn K.M., Marsh J.L., Bottlang M. Hinged external fixation of the knee: intrinsic factors influencing passive joint motion. J Orthop Trauma. 2004;18(3):163-169. doi: 10.1097/00005131-200403000-00007.
  87. Виленский В.А., Поздеев А.П., Бухарев Э.В., Поздеев А.А., Зубаиров Т.Ф., Соломин Л.Н. Ортопедические гексаподы: история, настоящее, перспективы. Ортопедия, травматология и восстановительная хирургия детского возраста. 2015;3(1):61-69. doi: 10.17816/PTORS3161-69.
  88. Vilensky V.A., Pozdeev A.P., Bukharev E.V., Pozdeev A.A., Zubairov T.F., Solomin L.N. [Orthopedic hexapods: history, present and prospects]. Ortopediya, travmatologiya i vosstanovitel’naya khirurgija detskogo vozrasta [Pediatric traumatology, orthopaedics and reconstructive surgery]. 2015;3(1):61-69. (In Russian). doi: 10.17816/PTORS3161-69.
  89. Мирошниченко В.Ф. Миофасциотенодез коленного сустава. Самара; 2001. с. 11-22.
  90. Miroshnichenko V.F. [Myofasciatenodesis of the knee joint]. Samara; 2001. p. 11-22. (In Russian).
  91. Г убин А.В., Борзунов Д.Ю. Парадигма Илизарова. Гений ортопедии. 2012;(4):5-9.
  92. Gubin A.V., Borzunov D.Iu. [Ilizarov’s paradigm]. Genij ortopedii. 2012;(4):5-9. (In Russian).

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