Hamstring release and posterior capsulotomy for fixed knee flexion contracture in haemophiliacs

Between 1977 and 1981 hamstring release (n = 27) and posterior capsulotomy (n = 22) were performed on 27 haemophilic patients. The follow-up of 19 patients is documented for at least 5 years after the operation. The mean age was 30 years (15-40 years), the mean follow-up period was 12.5 years (5-20 years). Postoperatively 16 of 19 knee joints achieved immediate full extension, three patients showed 10 degrees extension deficiency. In the long run the original good result could be demonstrated in just 11 patients. Using the Orthopedic Advisory Committee of the World Federation of Hemophilia (OAC) Scores there were three good, 12 satisfactory and four poor results. In minor forms of arthropathy a hamstring release with posterior capsulotomy is the only recommended operation. In severe forms we would actually recommend a combination with other procedures such as arthroscopic synovectomy or joint replacement.