Video Gallery

Video Gallery

To View the Video

Management of Chronic Osteomyelitis and Knee Arthrofibrosis: Debridement with Judet Quadricepsplasty

March 01, 2017

Contributors: Sanjit R Konda, MD; Kenneth A Egol, MD; Nina Fisher, BS

Introduction: This case presentation demonstrates the management of chronic osteomyelitis and knee arthrofibrosis through debridement, insertion of an antibiotic nail, and judet quadricepsplasty. Methods: The patient is a 43-year-old male who is 16 years status post plate fixation for a right femoral shaft fracture treated in a foreign country. He had progressively worsening knee range of motion over the past year with episodes of intermittent drainage. He had undergone arthroscopic lysis of adhesions with no improvement in his knee range of motion. At time of presentation, his knee range of motion was 0 to 5 degrees. Infection markers were consistent with chronic osteomyelitis. Results: Given his history of prior open plating of his femoral shaft fracture, it seemed likely that the patient had developed adhesions between his quadriceps and femur at the site of previous surgery. Therefore, the patient was indicated for a judet quadricepsplasty procedure of the right femur to increase his knee range of motion and an irrigation and debridement of his thigh compartment including the intramedullary canal of the femur with associated antibiotic nail placement into the femoral canal. The judet quadricepsplasty consists of a stepwise release of structures around the knee, thigh, and hip in an effort to release a flexion contracture of the knee. The indication for a judet quadricepsplasty is a flexion contracture of the knee due to a combined contracture of the anterior knee joint capsular structures and adhesions of the quadriceps to the femur. Typically the former is a result of the latter. Conclusion: The patient’s infection was cleared after six weeks of antibiotics, and his antibiotic nail was removed at three months postoperatively. At one year postoperatively, the patient had symmetric and full knee range of motion, and no sign of reoccurrence of his infection.

Results for "Surgical Techniques"

5 of 10
5 of 10