Arthroscopically Induced Posterior Capsular Fibrosis to Correct Symptomatic Hyperextension of the Knee


      We present a technical note on 2 patients with post-traumatic symptomatic hyperextension of the knee treated with a new arthroscopic technique. Both patients were of similar ages with similar injuries resulting in an excess of hyperextension at the knee with resulting instability and pain. Both patients had not improved with a variety of nonoperative measures and 1 attempt each at simple arthroscopic debridement of the damaged tissue. Our technique involves carefully scarring the damaged posterior capsule arthroscopically, followed by extension block bracing for 12 weeks. In 2 patients who had not improved with previously described techniques, we achieved a correction of the excess hyperextension with resulting improvement in their symptoms. Two years after surgery, both patients had significantly improved Lysholm and Tegner activity scores and had returned to work. We believe this technique to be reliable and reproducible.
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      Linked Article

      • Treatment of Hyperextension
        ArthroscopyVol. 26Issue 8
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          I read with great interest the article by Bourke et al.1 in the March 2010 issue. As a huge fan of the utility of posterior portals and the unique effectiveness of the trans-septal portal, I applaud the authors for their creativity in attempting to expand the use of posterior compartment arthroscopy. However, I do have some significant concerns about the science of their conclusions.
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