Ilizarov treatment of severe type I fixed flexion deformities of the knee joint

Background
Two types of flexion contracture of the knee can be distinguished: the one associated with joint destruction and ankylosis, and the other in which joint anatomy and mobility are preserved.
Aim
This study was carried out to assess the results of gradual correction of severe type I fixed flexion deformities of the knee joint using Ilizarov external fixator.
Patients and methods
This study included eight patients having severe type I fixed flexion deformity of the knee joint. The preoperative fixed flexion deformity ranged from 50 to 80° (mean: 67.5±8.3°). All knees were stiff preoperatively. The cause of the deformity was juvenile rheumatoid arthritis in four (50%) patients, infection following open reduction and internal fixation of a tibial plateau fracture in three (37.5%) patients, and repeated hemarthrosis of the knee in one (12.5%) patient.
Results
Full correction was achieved in all patients following removal of the fixator. The follow-up period ranged from 12 to 36 months (mean: 24±4.3 months) following removal of the brace. Two (25%) patients had no recurrence of the deformity, whereas the remaining six (75%) cases had partial recurrence of the deformity that ranged from 5 to 25° (mean: 11.25±9.5°) during the follow-up period.
Conclusion
Ilizarov gradual distraction is an option to improve the quality of life of patients having severe type I fixed flexion deformities of the knee joint despite the high rate of partial recurrence.